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from:Ib1AC IfJC. <br />SITE ADDRESS <br />So�/ 4niD�n/ <br />LEOA LOT NO. <br />To:914252578857 12/OB/2010 01:35 �436 P.002/003 <br />PE��MIIT AI�PLIGATION <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />a25-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM <br />BLOCK <br />� ✓�,e� rr f/dusiNG �9crr�fa'� � <br />TENANTNAME I <br />N � /9' <br />/NC, <br />CONTA.UCENSEY /�yf}.e��"�'�bBFJ. <br />USE OF BUILDINC3 <br />�ARCEL TAX I.D. • <br />TAACT OR SUODNISION I <br />- 27�5 /5�`',!'�lC�e� . �'1� <br />PERMR <br />PHONE <br />P MITN <br />IU(z-��-� <br />s�zs-3o3 -�i3 <br />,N.O(ntf" r„une 9/n0 <br />�+Vdr/ �U� %%' <br />HEA'f SOURCE I CONTRACT PRICE OF WORK <br />✓Electric ✓Gas_Olher <br />WORK DESCRIPTION //�j'��[�, �� i Y�—t/� r S,�`T.UI,�' � �iL�i�y- ���,�J i•�P�� <br />�/,�/G� fl� CLLG. T-* J� — �� <br />Y�'� (s�c ,��.-�-rr�.v-�r� covy oF•seoPs- o�' warL,e oQ,�;�a� <br />NO. � TYPE OF FIXTURE OR lIEM <br />/ Bathtub <br />� Lnvatory (wash basin) <br />_ Shower <br />� KHchen sink & disposat <br />' Oishweshor <br />� Clothes washer <br />„�,,: Weterhealer <br />Sink (service/badmop/etC.) <br />Backtlow preventer <br />Urinal <br />Drinking Fountein <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />NO. I TYPE OF FlXTURE OR ITEIA <br />tvc — air namung unils <br />Forced air systems <br />Gas piping <br />Wate� hoater <br />Gas Iireplace <br />Gas range <br />Clolhes dryer <br />Ranpe hood <br />Exhaustlan <br />Heat pump <br />Unit heater <br />Boller <br />Refriperation <br />Woodstovo <br />CfTY OF EVERtT'f' LOCAL 9ALES TAX CO�E IS 9103 <br />I horoby cerltKy ihat I have reed and ezamined this applica�lon and know Ihe samo to be Irue and correcl. All provislons of lews and <br />ordinaces gove;ninq Ihis typo oi work wil! be complied with whelher speclliod horein or nol. The Oranting ol e pertnit does �ot presuma <br />to giva euthority lo violate or cancol the provislon of any olher stalo or lowl law ropuletinp construclfon or tho poAormance ol <br />construction. Thet 1 em authorized by the ownrr of this property to pedorm the work for which opplicalion Is made and i comply with the <br />Sta�e Conlraclors,,L��w (�:2qjtCW end 296.200 WAC. <br />