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SITE ADDRESS <br />�05 <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />���orPS ,�ivs. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.ory <br />APF'LICATION`? ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. fF <br />� U�v .�'J.r �C40�� <br />BLOCK TRACT OR SUBDIVISION # <br />TENANT NAME <br />(�/�f l�h.., � �rnt ��• <br />CONTR. LICENSE p <br />USE OF BUILDING <br />2eS;�(c„ �.'� �- <br />L <br />CONTACT FOR PERMIT <br />b o c 1 ��� �ve,.c 1� Wl� <br />� R YL <br />QS�,o6 <br />njl.l cr�� N C 1 Z I C J <br />HEATSOURCE <br />_ Eleclric _ Gas _ OIhQr <br />0 <br />q�3�c� <br />PERMIT 8 <br />- C)U 2 <br />yz f- zsz- y96y <br />y zS-So�'�o�r3 <br />IE _..__' <br />CONTRACT PRICE OF WORK <br />� <br />98�' o <br />WORK DESCRIPTION <br />�P/ti.. ir S'1 17..i /KP�9G.t- '%��+vSt <'or..c v- 1.,.,' 1� /0 �k I� � NC`"` Fa�fi-v�S.- S��t� <br />�'1.�� f/{n� Fi-'1"i�LC� 1...��� /'l�^ r� �HC.-f f�PC.���CC/�Iw�.f �„� l✓Ji����7 �nOr�7 <br />� /_ <br />NO. I 1YPE OF FIXTURE OR ITEM <br />Toilel <br />�athlub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 6 disposal <br />Dishwasher <br />Clothes washcr <br />W ater heater <br />Sink (service/bar/mop/elc.) <br />Back(low preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greaso trap <br />Rool drains <br />Olher <br />NO. I TYPE OF FIXNRE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Rango hood <br />Exhaust (an <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigcration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i here�y ceritify lhat I have read and examined Ihis applicalion and know the same to be true and correcL All provisions of laws and <br />ordinaces c�overning lhis type of work will be complied wilh whelher specified herein or noL The granting of a permit does not presume <br />;o give aulhoriry to violate or cancel the provision of any oiher stale or local law regulaling construclion or the periormance ot <br />conslruction. Thal I am authorized by Ihe owner of lhis property lo periorm the work for which applicalion is made and I comply with the <br />SIat�Contractors La�v 18.27 RCW and 29G.200 WAC. <br />� 9-zaa <br />