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— - .� <br />PERMIT �� 'PLICATIC)N <br />CITY OF EVERE'� .� PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITEADDRESS ,' 742 <br />� 1 � " � ivc,U'i f."� . <br />LEGAL LOTNO. BLOCK TRACnT <br />DESC. I'i'I'�'_ ��� '�77 _- E <br />PARCEL TAX I.D. # <br />��i�1S ��� �l <br />QlV', <br />....,.�n -- - <br />�? p �ti,��.�•r:,,�.si ;4 �n.r,-r1� ( �� � °. I�JF l2�ZG <br />TENANT NAME CONTACT FOR PERMIT <br />1/�/,�.J j' I �on--� �o1:5a�l�? <br />CONTRACTOR �7I-0 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />D�C1'u` X <br />WORK DESCRIPT!ON <br />i - ►6 -� <br />�RMIT # <br />= � � iD - D <br />TY21P PHONF <br />fv �'i4�cc y2S 2 SZ f'tf; <br />PHONE <br />�Z5 � �l ����� <br />��,r t �,�� ADDRESS o �,� . 7 7 CITY2IP <br />Q'' Jr L��i " C i7C (�. �(_�� C t-,v <br />PF�'�'rOc i�,'z�c, <br />P�Nv�tg�"5 <br />K mcNs� <br />HEATSOURCE <br />Eleclric L Gas _ Other <br />Cr�ii Ca-vvp.�LS[cW / Z <br />u/STMi�S � � c�f5 <br />�2c��fc, r.L• <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />ghower <br />� Kilchen sink 8 disposal <br />i Dishwasher <br />� Clolhes washer <br />� Waterheater <br />Sink (service/badmop/elc.) <br />Backflow prevenler <br />Urinal <br />Drini��ng Fountain <br />Floor drain <br />Grease trep <br />Roof drains <br />Other <br />PHONE <br />�P'`'� �-c�S z > z <br />l�'�".� <br />CONTRACT PRICE OF WORK <br />G r' C ?'J <br />rrr.-.t-r sYrn���>> A�n� �..,.�r,zC,�s ��:K. <br />(..ISt�r?T � ( G'� �,4`�J"�L"„�' / <br />N0. I TYPE OF FIXTURE OR ITEM <br />AiC — air handling units <br />� Forced air syslems <br />Ipp Gas pipiny <br />Z Water healer <br />Z Gas fireplace <br />Gas range <br />= Clothes dryer <br />�_ Range hood <br />� Exhauslfan <br />Heat pump <br />�_ Unil heater <br />Boiier <br />Refrigeralion <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I her:by ceritify that I have read and examined this applicalion and know lhe same to be true and correcL All pmvision� of laws and <br />o�dinaces governing this type of work will be complied �vith whelher specified herein or not. Tho granting of a permit does not presume <br />to c�ive aulhorily to violate or cancel lhe provision of any other slate or local law regulaling construction or the peAormance of <br />construclion. That I am aulhorized by the owner of this propery to perform lhe work for which application is made and I comply with ihe <br />Stale on r s L w� and 296.200 WAC. <br />�r�� _� ��-3`�G� <br />\ Y; <br />