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SITE ADDRESS <br />LOT <br />�ESC. <br />( <br />PERMIT APPl.ICATION <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 />.o �:�.. <br />� <br />C iT�t o� �ucrel-r <br />TENANiNAME <br />1J�A <br />ACT / <br />C6�f c. 1.0h1�-v r c�� o y� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />Nlia <br />WORK DESCRIPTION <br />6LOCK <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />3Uo'L wek�kurn �si <br />CON7ACT FOR PERMIT <br />.S (�rtvi J I� rv i 5`1 <br />�o ;ay. ia99 <br />HEAT SOURCE ��I <br />_ Elecfric _ Gas _ Other <br />'CCn.a�JG •_1e�5����.� Sfeei rl��%P�`ie- <br />�Ou%K W 4Y� <br />� <br />L�� ��5l,d„�1 i�. Sa�..t <br />NO. I TYPE OF FIXTURE OR ITEM <br />T011et <br />Balhlub <br />Lavarory (wash basln) <br />Shower <br />Kitchen sink & disposal <br />Dish�vasher <br />Clolhes �v2sher <br />Waler healer <br />Sink (serviceNar/mop/etc.) <br />Backllo�v proventer <br />Urinal <br />Drinkinc� Founlaln <br />Floor drein <br />Grease hap <br />Roof drins <br />Other <br />ySrZo <br />PHONE <br />(;�c,c�(i 9�iofn <br /># <br />2C�^$3�I� <br />�Izr) 7.�- 3G� l <br />CONTRACT PRICE OF WORK <br />.cy �r � � 13 � 5��,- <br />�•�c1�f1 ne,a wlU�4�NUM �4..]Pot„ ,,o�?.l. <br />� <br />�uG+nYOn• <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/G — air havdlinc� units <br />Forced air systems <br />G2s piping <br />Water heater <br />Gas fireplace <br />Gas rango <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />ome� 1=10.a�,1�t <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />I hereby cerli(y that I have read and examined this application and know tho same to be lrue and correct All provisions of laws and <br />ordinances c�overning this lype of �vork will 6o complied .vilh whether specified herein or noL The grantinc� of a permit does not presume <br />lo givo authoriry lo violalo or cancei tho provision of any other stato or Ioral law regulatinc� construclion or the pedormance of <br />construction. That I am authorized 6y lho owner of this property to per(orm lhe tiwrk fonvhich applicatfon is mado and I comply with the <br />Stalo Coniractors Law 18.27 RCW and 296.200 WAC. <br />�� C /�l �• �/�li�o <br />'/Z <br />