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S�TE ADDRESS <br />2g�13 �ocK <br />LEGA LOT NO. <br />DESC. <br />E �r�MIT APPLICATi.,,�J <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 />s - 5� 0.6 <br />Qp(,��� ll�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��l�g�...�— <br />� <br />BLOCK <br />PARCEL TAX I.D. # <br />�043�1�6500700 <br />TRACT <br />OWNER AO�RE55 GII�/LIP PMONE <br />G� t� rrav o�¢ct� rt�� ��t G 1� 1-v.tt�w t1i' hv� �v� Ws� 43 i-�j -�� 7 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />c�rr�. �[��t-�r�-as s�,� p�..- ��s�- azs 3s�t 8 l84 <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />p�w rt �a �y s-�csc�o r� �zoc� 2o+K �- s� ��,�tT�' 42s �v 2�52 <br />CONTR. LICENSE p W� <br />ti�E OF BUILDING <br />� 4�'�( GE <br />WORI< DESCRIPTION <br />��-a-��s�--� �/-� <br />��( M oc� � C1GlGl�� <br />NO. � TYPE Of FIXTUR[ OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash b2sin) <br />Shower <br />Kitchen sink S disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/elc.) <br />Back(low preventer <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Groase lrap <br />Roof drairs <br />eu,er <br />HEATSOURCE <br />Eleclric �Gas Other <br />CONTRAC7 PRICE OF WORK <br />1��660 ^ <br />�9�� ,�-�t'�-- {� <br />� � C H.�L_ � .—f�l-�.� .i�s�(y'✓l <br />NO. I 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 ranc�o <br />Cluthes dryer <br />Ranc�e hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SAI.ES TAX CODE IS J105 <br />I hereby ceritify lhal � have read and exainined this application and know Oie same lo he lrue and correct. All provisions of la�vs and <br />ordinaces goveming this type of work will be complied �vith whether specified herein or not. The granting o( a permil does not presume <br />lo give authoriry to violale or cancel the provision ot any other state or local law regulating construction or the performance ot <br />construclio;kThal�m authorized by Ihe o,vner of lhis property to perform Ihe work for which application is made and I comply wilh lhe <br />Slate �on(ral3(or� L�iR27 &GW and 296.200 WAC. <br />