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From:161AC INC. <br />To:914252578657 12��612012 14:25 #214 P.002100fi <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 � �� /�I � �/ <br />r <br />LEGA LOT NO. BLOCK <br />DESC. <br />� ✓E,�� Tr /�ousi,�/G �9ur��c'; <br />TENANTNAYE <br />� �� <br />, /NG <br />CONTR.LICENSEI /M�q.eZ "`�� g�t <br />USE OF BUILDING <br />PARCEI TAX I.D. • <br />TRACT OR 8UBUIVISION N <br />- 27/,�' /5�'' <br />TACT FOR PERMR <br />NEATSOURCE <br />✓Eleclric ✓Gas Other <br />N <br />�r.� . yz5-3o3-i�s, <br />PH(`NE <br />9�0 <br />yLf/-��/� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION //,�'�. ! i �'�) [,��CtJ' Sr�/�T--U�F ,' Fi'CJ�!/LL� /v�C�-.l C.OP��C , <br />/�ti/�S fo aLG F• k`f�-�'� � SEs �-.`rr�c,,�-� CvPy o�• SeoP� o�' wo 2�c UP�-o q a� <br />NO. � TYPE OF FlXTURE OR REM <br />Toilel <br />Bathtub <br />Levetory (wash 6asin) <br />Shower <br />Kkchen sink d dispasal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Slnk (servtce/bar/mop/elc.) <br />Backllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Giease irap <br />Rool drains <br />Othor <br />NO. I TYPE OF Fl%TVHE OR REM <br />AIC — alr han0ling units <br />Forced air systems <br />Gas plpinp <br />wator heatcr <br />Gas tfreplace <br />Gas range <br />Clolhes dryor <br />Ranpe hood <br />Exhaustlan <br />Heat pump <br />Unit heeter <br />Boiler <br />Refigeratfon <br />Woodstove <br />Olher <br />CfTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby curitily that I have reed and axamined this application nnd know the same to be true and correct. All provisions ol laws and <br />ordinaces governing this type ol work wfli be complied with whelher specified heroin or nol. The pranting ol a permit does not presume <br />to give authority lo vioiale or ca�cel lhe provision ol eny other stata or bcat law reeulatinp wnslruclion or lhe perlormance nl <br />construction. That I am aulhorized by ihe owner oi lhis proporty to perlorm the work lor which applicalion Is made and I comply wilh lhe <br />State ConVnctors,L@w t$:2py1CW and 296.200 WAC. <br />