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P�r�MIT APPLICATIG�J <br />CI'TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 /.. �I —OS <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />�/2G� (��� �/ - ��03 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREUIT CARDS ARE NOT ACCEPTED <br />SITEADDRESS J�`r �� `�U`� <br />_ ��� M <br />LOT NU. BLOCK <br />3 <br />TAX I.D. # <br />L2oo yo�z. � oo/- <br />TRACT � ^ �)� � � <br />�J <br />PERMIT # <br />C.�D/ - v�� <br />�ccnw� e�,�s�-n,��.e�.,^ �,i.�i, I$IS �71T�' �ut NE Sno�w,�,isl• ��90 Y2�2/Ko41� <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />��ss� Crus1-,./ yzSdISo410 _ <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />�reuw� G,nsb.Nc,�,�n '�.,.�c, IgIS l�l�`rwEur sna�.�sl. �So 4zs�18vY1� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />S �=12 <br />WORK DESCRIP'iION <br />NO. <br />HEAT SOURCE <br />_ Electric � Gas _ Olher <br />� �/ <br />y�.P �c�.� �-�-- / � , <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM N�• <br />Toilet � ' ' i <br />Bathtub <br />Lavatory (wash basin) / <br />Showe� <br />Kitchen sink & dispcsal <br />Dishwasher <br />Clothes washer <br />Laundry trey r <br />Sink (service/badmop/etc,) <br />Backflow preventer <br />Urinal <br />Drinking F�untain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />�����; ��� <br />,C—�a..-�j� /�.5 O <br />,� l� _. O <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan I77� <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Waadstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3�05 <br />I hereby ceritity that I have read and examined this application and kno�v the same to be true and correct All provisions of laws and <br />ordinaces governing this rype of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the perfortnance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with lhe <br />State Con« actors Law 18.27 RCW and 296.200 WAC. � Ci �( <br />�� ���.. <br />� ��i <br />