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SITE ADDRESS <br />7s�os ti <br />LEGA�f. LOT NO. <br />PEhtMIT APPLICA►TION <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 />BLOCK <br />�Ti�c2 ��� /�ssoc�u��s <br />TENANTNAME K���..L .�/t ��,�. <br />��yU/✓� fle z � e utio <br />CONTRACTOR -r%� D <br />CONTR. LICENSE p <br />USE OF BUILDING <br />PARCEL TAX I.D. p PERMIT N <br />D �3o�oz - os z <br />TRACT <br />ADDRESS CITY2IP PMONE <br />�L�OS�/i��1% Sdm1A14 �/S�i IP�/, �SSe. Q.f�A�. <br />� . .,.� <br />CONTACT FOR PERMIT <br />ADDRESS <br />HEATSOURCE <br />_ Elechic _ Gas _ Other <br />WORK DESCRIPT�ON <br />T �c+�� f �, p �-e vP �rLe�i7L <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchai sink 8 disposal <br />Oishwasher <br />Clolhes washer <br />Waler heater <br />Sink (service/barlmop/etc.) <br />Eack(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. <br />Zo6_ 3.�5�- 5�9�' <br />CITY2IP PHONE <br />CONTRACT PRICE OF WORK <br />;'<<�?7%c� <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />W aler heater <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />I hereby cerilify that I have read and examined Ihis applicalion and know lhe same to be true and correct. All provisions of'aws and <br />ordinaces guverning lhis type o( work will be complied with whether specified herein or noL The granting of a permit does not presume <br />to give authority to viola:e or cancel the provision of any olher state or local law regulating ccnsWction or the pe�formance ot <br />construction. Thal I am aulhorized by Ihe owner of this property to perform the work for which applicalion is made and I comply wilh the <br />Stale Cqhtr clors Law 18 CW an 296.200 WAC. / � <br />��"�7i 1" � [ Z 2 / �%�D <br />