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SITE ADDRESS <br />z�z� i/ <br />LEGAL LOT NO. <br />( <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE f, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'�' <br />a..r Ibl� <br />BLOCK <br />PARCEI TAX I.D. A <br />TRACT OR SUBDIVISION M <br />� II <br />C70i'�d7J `I- B/ir�J�'.4 /�i',c��✓it�C Z�ZOj-/•�/iaw✓if'✓c 6v.�.,If-aM. <br />TENANT NAME CONTACT FOR PERMIT ' PHONE <br />E�AAAIL <br />T A G�S ���,�� ��. yas vs� grve <br />, '_� , -U 9 <br />CONTR. LICENSE # ' <br />hP5PlP1 �/iZ.T/� ��IO/(/ /3L �p s% 5� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�ee�e,.7z ��s,�:,j p/w.,l,�! <br />N0. I TYPE OF FIXTURE OR ITEM <br />Tailet <br />BalhWb <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEATSOURCE <br />Eleclric Gas Other <br />..� 6,�.�.vd.., . <br />/11eN�ea2 WA 7Jz 7 L <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systeins <br />Gas piping <br />Water heater <br />Gas (ireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereby cerilify that I have read and examined lhis application and know the same to be trur and correcl. All provisions ot laws and <br />ordinaces goveming this type of work will be complied with whether specifled herein or noL The granting of a permit does not presume <br />to give authorily lo violate or cencel the provision o( any other state or local law regulaling construclion or the performance of <br />construction. That I am aulhorized by lhe owner of lhis property to peAorm the work for which applicalion is made and I comply with lhe <br />Stale Conlractors Law' /18.27 RCW and 296.200 WAC. <br />%lLc/....! %/-�-r�-1 ��f/� <br />