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SITE <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SER\/ICES <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 />l� ' <br />LEGAL� LOTNO. ' BLOCK <br />DESC. <br />OWNER <br />TENANTNAME "� tl�f l�l�C <br />�Q' S l d ►.J S19Lc� �, <br />CONTRACTOR <br />%%�L /�!q►� �Q'C`7E+.•L� <br />CONTR. LICENSh�R <br />� � T � � � <br />USE OF BUILDING ^ <br />/Le-I-Q �C <br />PARCEL TAX I.D. k <br />�Ol�/2c�t2oc��o�] <br />TRACT <br />CONTACT FOR PERMIT <br />Tw� vti�\K <br />ADDRESS <br />`�s/S� a'r��7?" <br />HEAT SOURCE <br />�{ `�°� ��� <br />PERMIT N <br />�L-n�!- /� <br />PNONE <br />y� s s. <br />CITYIZIP PHAp NE <br />�V /KQYCI �'T <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION , <br />SN5'frr !�_ � _..1—L-L� <br />co >✓ �'x-tF,.- �c�.� wn � <br />NO. I TYPE OF FIXTURE OR ITEM <br />TOilet <br />Bathtub <br />_ Lavatory (wash basin) <br />Shower <br />_ Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />_ Sink (service/bar/mop/etc.) <br />BackBow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />C[�71 <br />,2 /2v c� <br />S� IZGa <br />CONTRACT PRICE OF WORK <br />�, iaa , �� <br />t Gt2 G L GL7o u�l'Y•=n� �'�Q �, <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />PJC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify that I have read and examined this application and know lhe same to be true and currect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit doe� not presume <br />to give authority to violate or cancel lhe provision of any other state or local la�.v regulating construction or the performance of <br />cons tion. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Sta ontractors L�vr�t�.2� RCW and 296200 WAC. � � <br />-. <br />