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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />3�3 � ,2o�,�u6* u.�v� cv� <br />LOT NOt. <br />/S t �% <br />C�- n � n-� <br />TENANTNAME <br />� R � �.�.++-•..-, .... <br />CONTR. LICENSE p <br />PARCEL TAX I.D. # <br />�3�i sa2 �,s �o�� <br />)CK TRACT OR SUBDIVISION # <br />�— fVI:YL�P D� V . M <br />PERMIT # <br />6n-1�� i�.l 363� R-o�x�:��L�GI•.� L•�/�Y�T� v�A �?1'LJ/ ` ' <br />CONTACT FOR PERMIT PHONE�QzJ" Q�LL- �U v <br />i�/a�. L fjP �iTi.o �.J <br />E-nna� �Bw,�; T �J ,N: t <br />/� A:'DRES I /ZP A,Z�- <br />�✓ C�v^u7�W c� U(" � �i 0 i � c l�l•.�L•ZA�I.'v'� [��it-F.�ST �"LJ / ' <br />� 3)y-S"IJ3 <br />Pv � 1� c'z 4 6-P � ��//i/`i /� ('� <br />USE OF BUILDING <br />2�: Si O �,-� u: <br />HEATSOURCE <br />_ Fleclric _ Gas _ Olher <br />PRICE OF WORK <br />ZG, ¢v J <br />WORK DESCRIPTION � <br />,4�rn.�M„-io ,✓ � F'�c-r, ,� �,� � (3� �-+ �vo n-. � � �v n� o�.., D.��. <br />a- <br />NO. I TYPE OF FI%TURE OR ITEM <br />� l0ilel <br />Dalhlub <br />� Lavalory (wash basin) <br />/ Shower <br />Kitchen sink 8 disposal <br />Dish�vashe� <br />Clolhes �vasher <br />Waler heater <br />Sink (servicclbadmop/elc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grcase trap <br />Roof drains <br />�Iher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handlinc� units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes Cryer <br />Range hood <br />Exhausl (an <br />Heal pwnp <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cerili(y Ihat I have read and examined this application and know Ihe same to be truc and correcl. Ail provisions of laws anJ <br />ordinaces goveminc� this type o( work �vill be complied with whether specified herein or not. The g�anting of a permil does nol presume <br />to give :.ilhority to violate or cancel the provision of any olher sl�te or local law regulating consWctio� or the pedormance of <br />con;truction. ThatJ aiii a thorized by the owner o( Ihis property lo perform ihe work for which application is made and I compiy with the <br />State Contraclors L� .27 RCW and'296.200 WAC. <br />� -.�� �/,/d7 <br />Signal e o( OwnadCon!raclor/Aulhorized Agenl ale <br />