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SITE ADDRESS <br />703� M< <br />LEGA LOT N0. <br />DESC. 3 <br />PD� h <br />TENANTNAME <br />�, ,_ <br />CONTRACTOR <br />CONTR. LICENSE N <br />USE OF BUILDING <br />�� <br />P�MIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everetr.va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� �d <br />BLOCK <br />r <br />•, . � <br />� •. � <br />En¢u-�r;rrr <br />),Q FivT-� u <br />PARCEL TAX I.D. # <br />,�v�q»-ow-, � �-�� <br />TRACT <br />/11J2. —00/�U <br />i�9�o as� �9✓� ui u�aL <br />CONTACTFORPERMIT <br />�'l/�i-'� KL°rtiC'IC� <br />ADDRES <br />r6y/o � c�! <br />�� pp - - <br />PERMIT / <br />� i� a 3- � �-- <br />rnvn� <br />ylr �7/'�'rlY <br />PHONE <br />Y�'�Z `� <br />CITY2IP <br />�'icz �rhNc�fl <br />•,:• � ;,�' � <br />HEAT SOURCE <br />_ Eleclric � Gas _ Other <br />WORK DESCRIPTION <br />��, ��� o� b� r �� r�-� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/badmop/elcJ <br />BackOow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Olher <br />PHONE <br />;�.,�,- � �r �s� <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined lhis application and know lhe same to be true and cortect. All provisions of laws and <br />ordinaces goveming this lype of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />lo give aulhority lo violale or cancel lhe provision of any other slale or local law regulating constnicdon or the pedormance of <br />construction. That I�m aulhorized by lhe owner of this property to perform lhe work tor whicti application is made and I comply wilh the <br />St ontracl Law 18.27 RCW and 296.200 WAC. <br />� / _.. �% -� /_/_� <br />'�v <br />