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SITE ADDRESS <br />BI�� � <br />LEGA LOT NO. <br />DESC. <br />C.n� !� /�on�eS <br />TENANTNAME <br />I�DY� 2 <br />PERIVIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIC�S <br />3200 CEDAR STFEET, EVERETT, VJA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTcD FROM 8 AM TO 4 PM <br />PARi;EI TAX I.D. N <br />28osoq oo3a goc <br />BLOCK TRACT OR SUBDIVISION # <br />ADDRESS <br />3526 Cwktr�ic��e 2d <br />ICONTACT FOR PERMIT <br />� ,n c� ��, r�-� <br />Co,�,,,,�,'C�� r're �ro�eCtiBn <br />-G'd� <br />PERMIT � <br />N)f (leM , 5$Z�j 36b -4� <br />�i"�"���8 ��9-3 <br />�_..,,�� r—ric �C�Firc <br />/�/�I 11V �Y rnvn� <br />i�rtiq ����ti e,,, ysz�3 s3o-8�8� o� <br />� <br />CONTR.LICENSEp ni7� �q� ��� �� I�R ���I�� �Pl���� �"�'�� ������ <br />GO/�1/V1�Fri�� rv� <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />J <br />`, ��I�, �q� �� K�S����`�G �.Electric __Gas_Other ��y,� O� <br />WORK DESCRIPTION , <br />�i„s�A!I � V�f/ 13b �Mpi�qv,� ✓'esic�ew��a� �{ii�s���nker Sys�"ev� rk c� nev�1 -��,��C' <br />W� <br />� P h�Url�l�� Ur�� �i D h^ Z. <br />NO. � TYPE OF F�%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />W ater healer <br />Sink (service/barlmop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Root drains <br />Olher — <br />NO. I TYPE OF FIXTURE OR ITEM <br />FUC — air har.diing units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify tha� I have read and examined this applica�ion and know Ihe same to be true and correcl. All provisions of laws and <br />ordinaces governing this type o( work will be complied wi�h whether specified herein or not. The granting o( a permit does not presume <br />to give authority to violate or cancel lhe provision of any other state or local law regulating construction or �he performance of <br />consirucJ' hal I am aulhorized by lhe owner of Ihis property lo pertorm the work for which application is made and I comply with the <br />Stale Cfiqlracl Kpw 18lL�( RfcYV an� 296.200 WAC. , � � I. <br />d�� (,� �� � � )`� - <br />lgent at�— (�,? <br />