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a <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — �wvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SRE ADDRESS PARCEL TAX I.D. K <br />�o� � MoNtt�NA W� Oo5S2400� 0�200 <br />LEGA LOT NO�.1 BLOCK TRACT OR SUBDIVISION K � tY �.,, <br />DESG � �,[_ (A'I RA�I`iC,Ha �N�RGrT7� <br />( <br />G'l�' �IIIC,i i 1�J..1.lYlc_ � C_'� <br />TENANTNAME <br />.� <br />�L`6RTR7�fib� <br />CONTR. LICENSE N� <br />1 <br />USE OF BUILDING <br />� i ( �_.(. ^ � --' � �,�~�=. � <br />�t�r ��c - o,-�'_., �Lc <br />� <br />CONTACT FOR PERMR <br />C'`�}�nCS Yu�i20\c� <br />i <br />� a �,� � � ��,r � _ ; c <br />�l � 1>�'-l�.ci.l l��"r� `l�"til <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION <br />c.a�sTR,ucT' P�TI o COU ��. <br />2�r`- o,, � ���_6�� <br />NO. I TYPE OF FIXTURE OH ITEM <br />Toile� <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitclien sink 6 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />floor drain <br />Grease trap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />� 1�6 l�` l�l� , l� C�, <br />N0. I iYPE OF Fl%TURE OR ITEM <br />A/C — air handling units <br />� Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausttan <br />Heat pump <br />Unit heater <br />Boiler <br />RelriQeration <br />Woc,istove <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 9705 <br />I hereby cerilify ihat 1 have read and examined ihis application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />lo give authority to violate or cancel the provision of any other state or local law regulating construction or the performance ol <br />cons�ruction. That I am authorized by �he owner of this property to pertorm �he work for which application is made and I comply with the <br />Stam.CoNractors Law 1827 RCW and 296.200 WAC. <br />