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� <br />� <br />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 PARCEL TA% I.D. p <br />����(� Ha21.�,� �20� I Z�oy oZ �04 o1Zco <br />LEGA LOTNO. BLOCK TRACTORSUBDI\'ISIONp <br />/2..2s--pk <br />PERMIT R <br />�"U`b�d-04'� <br />jLS Ha�desc�r� 1.�C, �o i3w� L^a`si Shure.�,�e `1g11�0 LvS� 423 9zqb <br />TENANTNAME CUNTACTFORPERMIT PHONE �Izi-ybl-3+"�i <br />vCXX�C; C:r� i�%U¢ �Vc�nS e•Ma� 3'i� On�eC�C'�m-hvuc <br />C�rM Hec��ng c,ncl (ko�;n� ��-o. 6ox E�t3ho �n�,ac 4pctN ���i-'181•3�171 <br />CONTR.UCENSER CF�,,��(-HCqIp�yLf� <br />�� <br />USE OF BUILDING <br />��ice � 11�G�f e�lo�riC. <br />HEATSOURCE <br />_ Eleciric ^ Gas _ Other <br />WORKDESCRIPTION �,S�ci�I�S� Cuvl'�D�J �C ��� � C�) `,�I� $45{CJn <br />NO. I TYPE OF flXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Feuntain <br />Floor drain <br />Grcasc Irap <br />Rool drains <br />Other _ <br />CONTRACT PRICE OF WORK <br />� �D, CL"C). �0 <br />�Pr_ �uMQ . -- <br />NO. I TVPE OF FIXTURE OR ITEM <br />.� <br />� <br />NG — air handling units <br />Forced air systems <br />Gas piping <br />Walcr heatr,r <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Rangchood <br />Exhaustian <br />Hcat pump <br />Unit hcater <br />Boiler <br />Fefrigeration <br />Woodstovc <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 9105 <br />I hereby ceritity ihal l have read and examined ihis application and know the same to be Ime and correcL All provisions o� laws and <br />ordinaces goveming Ihis type ol work will be complied with whether specilied herein or nm. The gran�ing ol a permit does nol presume <br />to give authority lo violate or cancel Ihe provision ol any other state or local law regulating conslmctiun or Ihe performance ol <br />consimction. That � am authorized by the owner ol this property to perlorm Ihe work lor which application is made and I comply with Ihe <br />State Contractors Law 18.27 RCW and 29G.200 W�C. <br />��L <br />. � � <br />