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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 />�JZ� APPLICATIONS ARE ACCEPTED FROM & AM TO 4 PM <br />SITE ADDRESS � PARCEL TAX I.D. q I PERMIT �! � �, <br />LEGAL WTNO. <br />D[SC. <br />OWNER <br />FbRT ol� G-�f ERE,TT <br />TENANTNAME <br />`nt3o v�) <br />CONTR. LICENSE fl <br />USE OF BUILDING <br />n+Aa�Ne v�w v Z` <br />BLOCK TRACT <br />2911 'it'JND ST . <br />CONTACT FOR PERMIT <br />�0►� C. Svurt <br />� <br />EJaR�'�'T �A h25.388.0G04 <br />PHONE <br />ADURESS CITYIZIP <br />— HEATSOURCE I <br />Electnc Gas Other <br />ZoG • g55 � �2 <br />PHONE <br />CONTRACT PRICE OF WQRK <br />� Q,400 • = <br />WORK DESCRIPTION <br />GONg1Rc1CT �V� SttAF�D 5�l�► "�'�2 FAC�S L� 1�0I�f �P• TOP oF 516N � 11=0"p(;WECsR.I <br />APPRox. �o'-d� 5. oF �'ST" FAuNU W• u�aR+NE JiEw vR. 3O� PM1o�6ciwE isi.ANv �/ <br />�,/.tIDSCAPNG. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />Backllow preventer <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Greasetrep <br />Roof drains <br />Other _ _ <br />N0. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />__ Gasrange <br />_ Clcthes dryer <br />__ Range hood <br />__ Exhaustfan <br />__ Heacpump <br />__ Unit heater � <br />�Boiler n <br />_ Refrigeration �� <br />Woodstove <br />Other �� <br />N <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be lrue and mrrecL All provisions of laws and <br />ordinaces goveming this rype u1 work will be complied with whether specified herein or noL The granting ot a permit doos nol presumo <br />to give aulhority lo violate or c:mcei lhe provision of any other slale or local law regulaling construction or the pedotmance of <br />consWction. That I am aufhorized by lhe owner of this property to perfortn the work for which application is made and I comp�y with the <br />State Conlractor 1827 FCW and 296200 WAC. <br />/_� ' � ���� 9-//-06 <br />