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SITE ADDRESS <br />� � G{l�/t <br />LcGAL LOTNO. <br />GeSC. <br />—v� <br />TENANT N:..:7E <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />� BL !/D vQ�-� ��oo���� � ��� <br />BLOCK TRACT OR SUBDIVISION # <br />� .�v�/V S <br />/��iK��;-�� 6cdr� El�-.-�i %8� ��� <br />CONTACTFORPERMIT PHONE <br />E-MAIL <br />V VIY 1 RHIi I VR nuun�aa <br />�0 X� �G',✓.S?/'...ccc;�z�a �� L'!J� SL7��-�'�/�y/,S i✓C �/) <br />CONTR. LICENSE # .�G' <br />���'�'Jc EG � `i��'-3 i11i�1 •�l-/��0: <br />USE OF BUILDING <br />r� <br />HEAT <br />Electric _ Gas _ Olher <br />WORK DESCRIPTION <br />1j�C� ,�%,�'c�iGO <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (�vash basin) <br />Sliower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Back(low preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br /># <br />r!1 V 1\C <br />lr^,�7n �C'G-7���' <br />2n�c <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Waler healer <br />Gas (ireplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unit heate� <br />Boiler <br />Refrigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceriti(y Ihal I have read and examined this application and know the same to be true and correcl. All provisions of laws and <br />ordinaces c�ovemine� Uiis type of work will be complied with whethar specified herein or noL The granting of a permit does nol presume <br />lo give authority lo violale or cancel lhe provision o( any other state or �ocal law regulating conslruc;ion ur the pedormance oi <br />construction. That I am aulhorized/by lhe owner ol this prcperty to peAorm ihe �vork for which application is made and I comply with the <br />State Conlractors Law 1,8.27 RCV�j and 296.20U WAC. <br />� �L <br />