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�J <br />� <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.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �v�y(� �Gi� <br />SITED.DDRESS 3IV�• <br />��� �►�k� 1��� <br />LEGAI LOTNO. BLOCK <br />DESC. <br />OWNER <br />tio�.�,5 N � ��1,�.15� �.. <br />TENANTNAME <br />� �, p+� <br />CONTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING <br />h���z <br />PARCEL TAX I.D. # <br />-UUO -D�-3, <br />TRACT <br />PERMIT # <br />57�0 ���/�"" /'1�11<I IT�r �7g]-.%S� �2s– 35� D620 <br />CONTACTFORPERMIT PHONE <br />�J,��s N, E i5�-k C�-�� 3ss o�.z� <br />M / ADDRESS/ CITY2IP PHONE <br />V��1�i / C�c2"iP�Cc..c.'�'✓`. <br />f <br />WORK DESCRIPTION <br />�ev�o��s�t �xisfin,�c� <br />NO. I TYPE OF FIXTURE OR ITEM <br />� TOilel <br />� Bathtub <br />—T Lavatory (wash basin) <br />Shower <br />-T Kilchen sink 8 disposal <br />_ /L Dishwasher <br />Clnthes washer <br />1 Waterheater <br />Sink (servicelbadmop/elc.) <br />BackOow prevenler <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher <br />HEATSOURCE <br />Etectric ,Z Gas <br />CONTRACT PRICE OF WORK <br />Olher '��j�O0 O <br />t r <br />�j0�++� � � 11C�1A Qu)� � n. <br />i��bw���� <br />� r0.s h '�/Y..'I �N �`,b/ <br />� �,� •-•-�. (� s -te �'—S <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C – air handling units <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />Exhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y lhal I havu read and examined ihis application and know the same to be true and correcL All provisions ot laws and <br />ordinaces c�oveming this rype of work will be complied wilh whether specified herein or not. The granting of a permit does not presume <br />to give aulhorily to violate or cancel ihe provision o( any other slate or local law regulaling consWction or lhe peAormance of <br />cons�ruction. That I am aulhorized by the owner of this propeAy to perform lhe work tor which application is made and I comply with the <br />Slale Coniraclors Law 1.2� RCW and 296.200 WA � <br />�� �iLE��,...-.t,o i'►`� ��� ��Y-�v7 <br />