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RMIT APPL.ICATIUN <br />CI"fY OF EVEk�ETT PERMIT SERVICES <br />3200 C[DAR ;iTREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1a ..� <br />SITE ADDRESS <br />L�i�/.D�iv <br />LEGAL LOT NO. BLOCK <br />UESC. <br />OWNER <br />�xfrr�Y�fiNG AdTiS�a.�'. <br />TENANTNAME <br />�; <br />TRACT <br />�io7 �'o� <br />.CEL TAX I.D. # PERMIT# <br />_oo �_ oo� -o�o r/ 1�1(�l,n <br />CONTACT FOR PERMIT <br />S�SZ, 3o3.%/L <br />PfiONE <br />I ��n� .v�FT S�Zr' ,Tv � 6 3�d <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />���E-nf/ovri..,G A✓Ti/�. 3/n� ��EByAvE� ��Zo/ S�ZJ'.f�6390 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />S�/� <br />WORK DESCRIPTION <br />HEATSOURCE <br />_ Eleclric �as _ Ofher <br />.P�`'�/i/1�,fE�i'��of'� F.f'/fTi�vG /lE'f/D� %�CF <br />NO. I TYPE OF FIXTURE OR ITEM <br />?oilet <br />Bathtub <br />Ladatory (wash basin) <br />Shcwer <br />Kitchen sink & disposal <br />D;shwashcr <br />Clolhes washer <br />Waler healer <br />Sink (service/badmop/elcJ <br />Backflo�v prevenler <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />�d D, '�3r <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Ezhausl fan <br />Hcal pump <br />Unil healer <br />Boiler <br />Retrigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritily Ihat I have read and examined this application and know the same to be lrue and correci. All provisions of laws and <br />ordinaces goveming this type o( worA �vill be complied with whelher specified herein or noL The granting of a permil does nol presume <br />to give aulliority to violate or cancel lhe provision of any other state or local law regulating constructir.n or the performance of <br />conslruclion. Thal I am aulhorized by Ihe owner o( this property to per(orm the work lor which application is made and I comply with the <br />Stale Contr�p2aj8ye�w 18.27 RCW and 296.200 WAC. <br />