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�D� PERMIT APPLICATION <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 />SITE ADDRESS <br />—II°I G��'c*SD P�VE <br />LEGA LOT N0. BLOCK <br />oesa 1z ; �3 13S <br />�RNOy u tj <br />TENANT NAME I CONTACT FOR PERMIT pHONE 360. i'�i• 3Y41 <br />Li/CVNE Iq'S f'cgG/E J Iv� FI �{(/E�— E-MAIL Tim Llf (i��1S �1 W. (eM <br />ONTRACT R.`��•,� �ae�.n.t5 ADDRE S CI Y/ZIP PH��— <br />HYzo ��ant Sr yuaya.sas3 <br />CONTR. LICENSE p SNs H��'� ��� �"�� qbMo <br />(,OOMIGtt (L?PA <br />PARCEL TAX I.D. # <br />oy 584135'e I zoo <br />TRACT Ofl SUBDIVISION # <br />;rstnl�viEtiv rat�p <br />la e�+�1- r3�K l3f <br />CITV2IP PHONE <br />��c0o`i m6TLctE��� �j�q GMr.�I� A�� ELEtzETT� '/87r1 y2f.33f. <br />USE OF BUILDING <br />jZE510E� • <br />RK DESCRIPTION <br />� DEmkvl'�"lorv (� <br />S�7 <br />HEATSOURCE <br />_ Electric � Gas __ Olher <br />CONTRACT PRICE OF WORK <br />vu� <br />�I+vnE R*�l0 CoNS7wvcT19N OF nlEw kovhG oN Ea'�5'nnkt <br />NO. I TYPE OF FI%TURE OR ITEM <br />_3 Toilet <br />z 9athWb <br />� Lavatory (wash basin) <br />_� Shower <br />i Kitchen sink & disposal <br />� Dishwasher <br />1 Clothes washer <br />1 Water heater <br />Sink (service/bar/mop/etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling uni�s <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas lireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust lan <br />Heal pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby c ritily Ihat I hav read and ezamined Ihis application and know the same to be irue and correct. All provisions of laws and <br />ordinac ov nin Ihis ype ol work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give u hori to lal o cancel the provision of any other state or local law regulating consiruction or the pertormance of <br />consir ct n. at m utl orized by the owner ol Ihis property to perlorm Ihe work for which application is made and 1 comply wilh the <br />Sla�e o �r I r w 8.� Rri,W and 296.200 WAC. <br />