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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 <br />7vo� 2c�����;c-�� <br />LEGAL LOTNO. BLOCK TRACT <br />DESC. <br />PARCEL TAX I.D. 8 <br />=� OI 5�-I � 7 <br />a -�3-07 <br />PERMIT M <br />�C<<� A�i'G �f'C�I.C�"P f�� �t��l /\CI l�9iF� �G^L �iX�Cl/, /d`'ZC%I `�zi_�9� CiC <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />'�� �, ,�� �6 -7�9 - 66�5 <br />CONTRACTOR ADDRESS CINIZIP PHONE <br />G k.��-j 5��+ ✓� ,L. r-. C Zvf7' %%9'CdXii <br />CONTR. LICENSE R !� <br />+-• �, <br />USE OF BUILDING <br />S;ut(e �qc,�.�fy I <br />t%-io, S�� � NE Lk SI-e <br />HEAT SOURCE I <br />'G� I _ Electric _ Gas _ Olher <br />CONTRACT PRICE OF WORK <br />�Gysr"1. 5 9 <br />WORK DESCRIPTION ( r <br />��/O/L�(� i- i,)'Cl�'� -���CI �� l„C4t.�G1 � IQ � l�'l �Jr'^� �' IL�.:-�.-'•�"' <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tailet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry Uay <br />Sink (service/bar/rt�oo/elc.� <br />Back(low preventer <br />Urinal <br />Drinking Fountain <br />Fioor drain <br />Grcase trap <br />Roof drains , 'r <br />Olher /y1q��7 �A��F i�2'ii�. ✓C,0%lccc.r.� <br />N0. I TYPE OF FU(TURE OR ITEM <br />AIC — air handlinc� �mits <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firepiace <br />Gasrange <br />Ciothes dryer <br />Range hood <br />Exhaust(an <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS J106 <br />I herehy ceritify that I have read and examined this appiication and know the same to be lrue and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting o( a permit does �ol presume <br />to give authority to violate or cancel the provision of any other state or local law rey:�laling construction or the peRortnance of <br />construction. That I am authorized by the owner of this property to perform the w�rk ter which application is made and I comply with the <br />State Contraclors Law tb27 RCW and 296.200 WAC. <br />