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SITE ADDRESS <br />r. �OG Hk�:1� o J i <br />LEGA LOT NO. <br />OESC. <br />OWNER <br />$cS //AC�'c5v'J <br />TENANTNAME <br />C7oCJ��' I�%i <br />USE OF <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S i REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org b�� 2��� I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� �. p/�� <br />PARCEL TAX I.D. S PERMIT I <br />•'t'r�t�..%a ZBo�OZc�o v�Zvo <br />BIOCK TRACTORSUBDIVISIONN <br />ADDRESS CITY2IP PHONE <br />v <br />`OSUa'(OVfUs� SijO.FfG/.vE cc1F' /d�/CnG <br />I CONTACTFORPERMIT PHONE yLS�JJ2 / <br />S`'G� ..�EcH�.��c•�� <br />.c� L <br />r�L <br />,���t�� <br />13yt5-2rr��5� 5� �, <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />�..��iJ✓/cc � <br />�� y���2 �/IS v�2 i� <br />CONTRACT PRICE OF WORK <br />�y,�t;a . �J <br />WORKDESCRIPTION f%DD 2iZES�z<=C>.MS Tz% ��5�/�✓c�SPA�E /NC�LnUD�NC7 L\/ZY'cE i�� <br />If%Ql«JAL� / �CGL;/� /72A/.2:� i�[A✓�TG�'�f5 / WT74.�'/iricii��.� /Ji'�%U �.S�U� <br />/n� �t%l,e�l/OUjE ��:��. <br />NO. I TYPE OF Fl%TURE OR ITEM <br />Toilet <br />Jathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes wasner <br />Water heater <br />3ink (service/badmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling uni�s <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhauslfan <br />Hea� pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Waodsiove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and ezamined Ihis application and know ihe same to be Irue and correct. All provisions of laws and <br />ordinaces�governing ihis type ot work will be complied with whelher specified herein or not. The granting ol a permit does not presume <br />to giye author y to violate or cancel Ihe pmvision ol any other state or local law regulating construction or Ihe peAormance of <br />con5truction�hat I am authorize�J by the owner ol Ihis property to perform the work lor which application is made and I comply with Ihe <br />St�ale Conir tors Law t827 RG�/ and 296.200 WAC. <br />�� <br />