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SITE ADDRESS <br />=°r.zU <br />LEGALI LOT NO. <br />DESC.r �p"LU <br />— — — —� <br />PERMIT APPLICATION � <br />CITY OF EVERETT F`ERMIT SERVICES � <br />3200 CEDAR STREET F'VERETT WA 98201 � <br />425-257-8810 — FAX 425-25�-8857 — www.evereltwa org 3_-� —(�� <br />APPLICATIONS P. i� /�CCEPTED FRnM 8 AM TO 4 PM <br />�_cn1�4RfJ ��('� <br />o�ocK <br />SC c1 T ��-S�utl� <br />TENANTNAME <br />CONTRACTOR <br />�Jl�jp It���Et'-I�R�SES 1NC <br />CONTR. LICENS[ # <br />USE OF BUILDING <br />�Ji �j�Nlll�i <br />WORK DESCRIPTIQN <br />NO. <br />PLUMBING <br />PARCEL TAX I.D. # <br />Ub� 5.3 I �IZUc�ol <br />TRACT <br />3c'� c �.�ot�ARU D�, <br />ICONTACTFOR PERMIT <br />�Ni�L R�F�J <br />AD�P.[SS <br />; 7rt (.6 t' A��- N� <br />TYPE OF FIXTURE 04 ITEM <br />Tuilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbadmop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />PERMIT # <br />�U -7 C7 ( � b�o <br />�v���r� y�z� l �/�> �? 5 7 5�1 <br />PHONE <br />4,'zs sor 3s�3 <br />CITY2IP PHONE <br />MA�NSuuk. Gj(,✓z7c �« so� 3s y3 <br />HEATSOURCE <br />L [lectric __ Gas _ Olher <br />NO. <br />CONTRACT PRICE OF WORK <br />� 35i ODU � � <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />W aler heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Ranc�e hood <br />Exhausl(an <br />Heatpump <br />Unit healer <br />Boiler <br />Refric�eralion <br />Woodslove <br />Other t�k Koa��� (lf�kknµ,C <br />Gov� � ht N Gµ' � � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lhat I have read and examined Ihis application and k.no�.v the same to be irue and correct. All provisions ot laws and <br />ordinaces governing Ihis type ot work will be complied with whether specified herein or neL Tho granting o( a permil does not presume <br />to give authority o violale or cancel the provision o( any o�her state or local law regulating consWclion or the peAormance of <br />construclion. T a I am authorized by the owner o( this property to perform the work for which application is made and I comply with the <br />i Stale o Iract�aw 18.27 RCW and 296.200 WAC. � <br />V� <br />Signalure <br />- 2'L�U <br />��z <br />