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SITE ADDRESS <br />2 3 Z �, ; <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />� n ��'� /�% �/ <br />TENANTNAME <br />PErtMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />r; i-,`'tt �C_ <br />T—O�GCK <br />z 3z� /� <br />CONTRACTOR <br />�y/,,./r.- Srt I�s'� S�.-J <br />CONTR. LICENSE # <br />�-y��-N�so�,Zit� <br />USE OF BUILDING <br />� �� <br />PARCEL TAX I.D. q <br />TRACT OR SUBDIVISION N <br />,ni{,- �ya*c. <br />CONTACT FOR PERMIT <br />.�i% � <br />/D ��Z. � <br />PERMIT # <br />� Ua i o- c�� N�o <br />�,�� yzs-g79-68�3 <br />PHONE <br />.y� �,n nuyr,� rnvnc <br />�ivrtiy /�s�t �'jr.v�/ L � <br />t/as'-zs%— G/ <br />y,�'=�, � <br />HEATSOURCE <br />� Eieclric _ Gas _ Other <br />WORK DESCRIPTION <br />NG,r�>cr „Ic� c/r <� jy s 7`r��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Oathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Oishwasher <br />Clo�hes washer <br />Waler heater <br />Sink (service/bar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher <br />�ONTRACT PRICE OF WORK <br />�J % S� <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC - air handling units <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas firepiace <br />Gas range <br />Clolhes dryer <br />Ran�o hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woadstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y lhal I have read and examined this applicalion and know lhe same to be true and correct. All provisions of laws and <br />ordinaces go�eming lhis type o( work will be complied with whelher specified herein or not The grenting of a permil does not pr�sume <br />to give aulhorily to violale or cancel the provision of any other slate or local law regulaling conslruclion or the peAormance ot <br />consiruclion. Thal I am aulhorized by lhe owner o( this property to pertorm the work tor which applicalion is made and I compty with the <br />Stale Contractor� La>v 18.27 RCW and 296.200 WAC. <br />�7 <br />�Q -Zz-G$ <br />