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SI7E ADDRESS <br />�/��O O�✓G <br />LEGAL LOT NO. <br />DESC. �,�-f � <br />K oF+ <br />TENANTNAME <br />n� � <br />Y <br />P�RMIT APPLICATIVnI <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 />PARCEL TAX I.D. S <br />Co S 96:7OdSoC <br />BLOCK TRACT OR SUBDIVISIUN # <br />pD S i�//a� r A✓JD %o <br />�-HI�Y` /'7�C•cI <br />c SI�Q�ar�C <br />GUnIKnl��vn % 17 ��nC�N�t(�L <br />/T <br />CONTR. LICENSE # ��' `��� G� <br />USE OF BUtI�LDING <br />,�dtGf I I l o {'� <br />WORK DESCRIPTION <br />/��-("d/ I i�^ <br />�/U OI/YG <br />PERMIT # <br />� I Y <br />�✓C/tc%% �/! <br />CONTACT FOR PERMIT PHONE s� <br />f a� I �,�r�5 T L�� �, ✓.�/K e�na� <br />—�66 —i.RYlfi�� <br />�µ,����5 ��<' £� a�� /f�r.! _F✓�F�/'7:4%N <br />-yG3 r�9 L/�Sr-�� ! 1����Z+ <br />� O /�r��f ��n.si <br />�o ,1��,� <br />%�-� e �ti . <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishviasher <br />Clothes washer <br />Water heater <br />Sink (service/badmop/elc.) <br />Backflow prevenler <br />Urina� <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Root drains <br />Other <br />-�s'9��oGz <br />yzt-239-zo6 <br />HEAT S/OURCE GON7 KAG i YKI�t �r vv�Rn <br />_ E�eclric ✓ Gas _ Olher d u <br />f 5 �,-i� � � /�' c�c� �'T r i� � c��-1 <br />NO. I TYPE OF F�XTURE OR ITEM <br />A1C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeratlon <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerility thal I have read and examined Ihis application and know lhe same lo be lrue and correcL All provisions of laws and <br />ordinaces goveming Ihis lype o( work will be compiied with whelher speci(ied herein or nol The grenting of a permit does nol presume <br />lo give aulhority to violate or cancel the pro� ision ot any other slate or local law rec�ulaling consWction or lhe perfortnance oi <br />construclion. That I am authon d by lhe owner of this property lo peAorm lhe work for v�hich application is made and I comply wilh lhe <br />State Contractors La�+ 18.27 CW and 296.200 WAC. <br />/� �� r% ��', `— / �C -!' % <br />1(� <br />