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P�RMIT APPLICATIL�� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />1 ZZ- h,d <br />LEGAL LOTNO. � <br />�1G/o <br />TENANT N/AMI <br />� �t �-� <br />BLOCK <br />� i 3 L%R�TD <br />�C �lC C'�og'�v <br />CONTR. LICENSE # <br />PARCEL TAX I.D.1� <br />ao�/� odo �oo `f-oo <br />TRACT <br />IZoZ � —03 <br />ADDRESS CITY2IP� <br />/ z� rh �/�i L rL�� �z L� Rk� <br />CONTACT FOR PFRMIT <br />.� l�i v � I SL= �a�' <br />USE OF BUILDING ��,5����-T��q L HEAT SbUF <br />_ Electric � Gas <br />WORK DESCRIPTION <br />���e.� ,�v�c�e� <br />.�, <br />NO. � TYPE OF FIXTURE OR ITEM <br />7oilet <br />' Balhlub <br />� Lavatory (wash bas�n) -!'� <br />1_ Shower <br />' Kitchen sink & disposal <br />Dishwasher <br />� Clothes washer <br />r Laundry tray <br />Sink (service/bar/moplelc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />CITY2�P <br />Other <br />PERMIT # <br />C° C�'A C�3 <br />�� 3 PHONE <br />�7 ��/Zs 35�7 z oZ� <br />PHONE <br />�l S� 3 `r / 20Z .6 <br />PH NE � � <br />r- <br />'z GS C.�s� � <br />CONTRACT PRICE OF WORK <br />-✓��; D�`' 2��'/3 <br />�� U,�s s �. � �� <br />� /-� <br />NO. I TVPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping � <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan ��/� <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceritity that I have read and examined this application and know the same to bo lrue and correct. All provisions of Iaws and <br />ordinaces goveming this type o( work will be complied wilh whether specified herein or noL The granting of a permit does not presur� <br />to give authonty lo violate or cancel lhe provision of any other state or local law regulaling wnslruction or the performance of <br />construcfon. That I am authorized by the owner of this property to perform the work for which applicaion is made and I comply with lhe <br />State C ntraclors La 18.27 RCW and 296.700 WAC. <br />L .�%v ' . -%tz _f t�.� � ��/� S� <br />��v <br />