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SITE ADDRESS <br />3231 � <br />LEGAL LOT NO. <br />DESC. � <br />�IAICI�Z MiYYLTi� <br />PtRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />-� �o a <br />PARCEL TAX I.D. # <br />DD'�3'1 S� � <br />TRACT OR SUBDIVISION p <br />�vrn.�.-T� o� v <br />�6�20 �s�`� �E <br />�ERMIT M <br />)/ S'U7� L ��47� - C� l2 <br />� C�TY21P PHONE <br />St�k�!'6n�i5 A 98256 ��S- Sa I--Go <br />TENANT NAME CONTACT FOR PERMIT PHONE 4,Z5 - SD I' �ob I� <br />�W�YP�EZ �AA{�-iIN E-MAIL <br />NTR T R � ADDRES �� <br />V w N�-��L <br />CONTR. LICENSE # <br />USE OF BUILDING <br />ynZ <br />— HEAT SOURCE I CONTRACT PRICE OF wORK <br />Electric ULGas _ Other <br />WORK DESCRIPTION <br />�i2Aw�i�G, Pun- �L�1M� NE> A�-"��n-���oN — 61nE,►� �N <br />� F�1-tu �Ic 13�7F+ eM �Ll�ruun n.� I N f3� ��-[ - <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />lavalory (wash basin)% <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflcw prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Rw( drains <br />Other <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Eahaust tan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Wondstove <br />Other <br />CITY OF EVERETT LOCAL SALES TIU( CODE IS 3105 <br />I hereby ceritify that I have read and examined lhis application and kno�v the same lo be true and corcect. All provisions of laws and <br />ordinaces governing this type o( work will be complied with whethe.r specified herein or noL The granting oi a permil does not presume <br />lo c�ive authorily to violale or cancel lhe provision of any other state or local law regulating con:'ruction or the perfortnance of <br />conslruction. That I am aulhorized by the owner o( this property tu pertorm the work for which applicalion is made and I comply with the <br />Stale Conlracto�r/s Law/,'I�{)ryC�7 RCW and 3�J6.200 WAC. <br />� L�A/�A/A�K. . /��Gl.t% � • � 1 � � D � <br />1 <br />2 <br />