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SITE ADDRESS <br />a3�� n�o.,���� <br />DESC. � L—� <br />OWNER <br />�t,'�� � <br />TENANTNAME <br />. �cl�c <br />PERMIT APPLlCATION <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 �� — D%'i� <br />PAflCEL TAX I.D. # PEflMIT # <br />,q-v� x � � <br />BLOCK TRAC70R SUBDI/�{ISION tt 7� , � <br />3 � 17�Ufi v� I'f TiC�IK/>�" l��/�S�c.i <br />�' r � �.� ���,�I <br />�'l J U �'�Hf.r <br />CONTRACTOR �,�,1 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />I"�S�c`i'bi_C <br />WORK DESCRIPTION U f%Dn1t <br />1^V�/aCe c� I��c li.c Fn��cr <br />Z33o �"�"�2�� �-v� <br />CONTACT FOR PERMIT <br />Dn,,,�l ���F; I�/c <br />HEATSOURCE <br />� Eleciric _ Gas _ Other <br />�(1ta 61� �`in �' � ��'di J <br />�✓/1�15 1 k•��IRCI� . � /IS,h/I <br />N0. I TYPE OF FIXIURE OR ITEM <br />Toilet <br />8a1hWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dislnvasher <br />Clothes washer <br />Watcr heater <br />Sink (service/badmop'etc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof dr 'ns <br />ome� I � Ccrr«�c� �nl���,�z«I �c1,�-�c <br />. � ���� <br />0 <br />c�� ,;rt- r�A ys��> �I <br />�) �7Z-��4yY , <br />,_,,.,.�, � <br />CONTRACT PRICE OF WORK <br />LI�C[ YFr L��Ce SiZ�n� �. <br />/1c�� �s ��e , <br />NO. I TYPE OF FI%TUfiE OR ITEM <br />NC — air handling units <br />Forced air systems <br />� � Gas piping <br />Water heater <br />Gas lireplace <br />� Gas range <br />Clolhes dryer <br />Range hood <br />Exhausllan <br />_ Hcat pump <br />Unit heater <br />Boiler <br />Rclrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALESTA7( CODE IS 3105 <br />I hereby ceritify that I have read and ezamined this applicalion and know the same to be true and correct. All provisions ol laws and ' <br />ordinaces governing this rype ol work will be complied with whether specilied herein or no�. The granting of a permit does not presume I <br />to give authority to violate or cancel Ihe provision ol any other s�ate or local law regulating construction or the pedormance of I <br />construc�ion. That I am aulhorized by the owner ol this property lo pe ��m the work lor which applica�ion is made and I comply with the <br />��°%State rac rs and 296.200 WAC. � <br />/'"'�/�t; �� �/ � I <br />