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SITE ADDRESS <br />LOT N0. <br />I <br />'RMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CF.DAR 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. k <br />18oyozooyp�6so <br />BLOCK TRACT OR SUBDIViSION • <br />9VA� wr�dow 4 Deo �' II S <br />ENANT NAME ��a ( EXrPG S �ON-f / <br />cA�ie� pe Le Q� p, <br />�� R�L iAA' �G F� l�G <br />CONTR. LICENSE � n C L i Q��/� 2�' <br />I� �1 <br />USE OF BUILDING <br />CGIi7PCT FOR PERMIT PHC <br />,-1��M 'Q 0 �✓ � I�n% e-M <br />po �io x Nz� Prer�a�/'�osa <br />Y—�'->� <br />PERMIT X <br />LL � n....�. . <br />3 0 3'!b <br />Zo6-z��-�yb/ <br />206 -Ld1-6636 <br />HEAT SOURCE �yBAr t CONTRACT PRICE OF WORK <br />_ Eleclric _ Gas x Other /S Q 0 D <br />WORKDESCRIPTION n.AQ Ne� ,��„I �f�s re�1 <br />i� �i y <br />w� / Sy.s�e•v� rro�n �X�sT��rr� ,610y. <br />NO. I TVPE OF FIX7URE OR ITEM <br />Toilet <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwaslicr <br />Clolhes washer <br />Water heater <br />Sink (servicelbar/moplelc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />T ���,. ,a�oy, �;� ;�To <br />y s He��s <br />� x �s T�'N� <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiier <br />Re(rigeration <br />Woodstove <br />Other <br />CITY (1F EVERETT LOCAL SALES 7AX CODE IS 9105 <br />I hereby certify thal I have read and examined this application and know the same to be irue and co�ect. All provisions oi laws and <br />ordinances governing ihis type of work will be cemplied wilh whether specified herein or not.'!he granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or 1he performance of <br />conslruction. That I am authorized by the owner of this property to peKorm ihe work for which aFplication is made and t comoly with lhe <br />State Coq►{aclors Law 18.27 RCW and 296.200 WAC. <br />3-3 i-/o <br />�� <br />z <br />