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SITE ADDRESS <br />3Z�j I G� RA�u <br />LFGAL I� �OI� <br />DESC. <br />��r��x � u � �, vutit�r�t <br />TENANT NAME <br />�.vn�rtn�.�vmn , I� <br />vl� <br />CONTR. LICENSE M <br />USE OF BUILDING <br />F �RMIT APPLICATIt�N <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 />PARCEL TAX I.D. # <br />�_ 1 OD43'15-��o-DlS-oo <br />BLOCH TRACT OR SUBDIVISION t!�1 <br />l � F'_I�-?Z.t f'i Di V 7� <br />tb�zo qs�r� s� <br />CONTACTFORPERMIT <br />Mik'.F M/���a <br />HEATSOURCE <br />p <br />-0/Z <br />Sr.�o�tax� �s�t � 9Ssz9 � Uts-sa� � <br />PHONE ({.2c� - � / - (�O � S <br />e.Ma� Mu/nodr�r.it Zy54 � <br />_ Eledric � Gas _ Olher <br />CONTRACT PRICE OF WORK <br />WORKDESCRIPTION ��ODfL �7��STIF�� �O�'`'�uh� ��� �� �� �D � �2�"� <br />titen�� ���r,�. Ae�a , par�+ Aa� , K�Tc� a,�, o s�rr�►.3� a+�► .�07� 9si <br />Av2YA T� � 4�-'A'7rD WITN HFrS F�?r�C.4�� �'`�� At� �lC�l�/G f7 `�7 /N B2� /tIL�D/s1 <br />NO. <br />� <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basir.) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes wasl�er <br />Water heater <br />Sink (serviceNar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greaso lrap <br />Roof drains <br />Other _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems — 1�E�! ktk'Mr►.�'/ <br />l;as pipinc� <br />1Nater heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. AII pro�isions of iaws and <br />ordinaces goveming this type o( work will be complied with whether specified herein or noL The granling of a permit does not presune <br />lo give aulhority to violate or cancel the provision of any other slate or local la�v regulating consWction or the peAormance of <br />conshuction. That I am 2uthorized by the owner ol Ihis property lo perform the work (or which application is made and I comoly with the <br />Slale Contract�rs La�v �.,27/\RCW and 19'6.200 WAC. n I^' J I <br />�n / � � <br />