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SITE ADDRESS <br />r���,� <br />LEGAL LOT � <br />I ;�.n`1i,S <br />l <br />PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-?57-8010 - FFJ( 4?.5-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCE{'TL"D FROM 8 AM TO 4 PM <br />I>le L�ok. 0.� <br />BLOCK <br />I,��ln5z �� <br />PARCEL TAX I,D. il <br />TRACT OR SUB�IVISION # <br />/S'/' /�lt ��•c� �q) <br />J <br />PERMIT # <br />Mo 450' <br />C-�._�Z113���,1 <br />v 1 Si SO4'�b/ <br />TENANT NAME CONTACT FOR PERMIT pHONE <br />r <br />� �� n+��l .S `I '� y� V, SN r' E•MAIL <br />�TRA R AODRES CITYIZIP P O <br />C,��l, N`�^.�-�'� y{- �zs-»�U38� <br />CONTR. LICENSE p 5 ��� S �� r°o"�W `Z V � V 2� 2 I I <br />`�,j 2 0 / <br />USE OF BUILDING <br />WOPK UESCRIPTION <br />r u�1 n Q�f �- I r- T? <br />l���� U t�-i c C `� <br />r.� � �., <br />HEAT SOURCE CONTRl1CT PRICE OF WORK <br />_ Eleclric _ Gas _ Olhcr f' � � � � �, �1 � <br />, <br />t•/ •�d'r�i c� <br />�p /�z�! i!.rSS 1�a�2� /izQ�prl, �rtr � � � I <br />� I .�j �i 1 (� � ti � S � ���assur� �a 'I� <br />�',Z �t 7 � — ��� ` C l � ' . <br />NO. I TYPE OF FIXTURE OR ITEM <br />ro�i�� <br />Dalhlub <br />Lavatory (wash basin) <br />Sho��cr <br />Kitchen sink & disposal <br />Oish�va,her <br />Clolhes washer <br />VValer healer <br />Snk (scrvicc/bar/mop/etc.) <br />5ackllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC - air handling unils <br />Forced air syslems <br />Gas piping <br />W ater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranc�e liood <br />Exhaust fan <br />Hcat pump <br />Unit healer <br />Bciler <br />Re(rigeralion <br />Woodstova <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y lhat I have read and eramined Ihis application and know the same to be �rue and correct. All provisions of laws and <br />ordinaces c�oveminc� Utis type of work will be complied with whelher specilied herein or nol. The 9ranting of a permit does not presume <br />to grve au�hority to viol. te or cancel Ihe provision o( any other stale or local law regulaling construction or ihe per(ormance of <br />construclion. Tha� I am authorized by the�owner ol this property lo perform Ihp �vork lor �vhich application is made and I comply �vith the <br />Slate Conlractors law 18.27 RCVy and 296.200 WAC. <br />/ , <br />, /',. , ! - .� �,n ;i . <br />� � . l��T/....-. �':' . /. � j: � <br />