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SITE <br />LOT N0. <br />DESC. <br />PERMIT APPLICATION <br />CITY OF EVERtTT PERMIT SER'VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />����t C'. �`v� <br />?ENANTNAME <br />1'Li�.Scl�`� �C.L�Ji� <br />CONTRACTOR [ <br />LT �'Cc� t' - <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />�I � � /—�-bti y—tiol-.�.3.,-y-� <br />BLOCK TRACT <br />�..__..___ /�V, <br />�/ � �r.G <br />CONTACTFORP <br />I�r-I-�� 7�a <br />�� �, G�rP <br />AODRESS <br />��SS <br />CONTR.LICENSEp /_� L/� 7SL ������ <br />L� G'1 <br />USE OF BUILDING <br />'�. u. �7 i t'., l ✓ �,,,, �' <br />ti <br />-557 <br />cmmP <br />Lcvi�d �v jr <br />5�<<�+G./��i 3 �/ <br />�— �3–o�O <br />RMIT N <br />� U� �� <br />( � PHONE <br />��6!' 7��`� <br />PHONE <br />� �� -- E��-,— l�/ �y <br />PHONE <br />� � (, -'ii-�i <br />g0�.7 <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric ^ Gas _ Other � J /'7 � � <br />WORK DESCRIPTION <br />Z�t y tk l 1 0�,,c� C, i,� .,nt.,�; c r✓1 K � fc,l.e-r. "rY� � / <br />J�vt C�X�tt�vc�f— ��nn� �).a.t �I11l��c V/i�}''';. �C <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />8ath�ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disoosal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (sen�ice/bar/mop/elc ) <br />Backflo�v preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />_ Grease trap <br />_ Roof drains <br />Olher <br />Ervu�cS-c No �c� <br />,l� �c r �.v �� <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />� Range hood <br />,� Exhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslo� e <br />� Other � �� r <br />CITY OF EVERETT LOCAL SALES TN( CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and wrrect. All provisions of laws and <br />ordinaces governing this rype of work will be complied with whether specified herein or noL The grenting of a permit does not presume <br />to qive authoriry to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construcuon. That I am authorized by the owner of lhis property to per(orm the work for which application is made and I comply with the <br />State ContraWars-L2w 7827 RGJN-en�Z95200 WAC. , <br />i7/�t <br />�� <br />��l <br />