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P�RMIT APPLICATION <br />CITY OF EVERETT PEaMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA g82p1 <br />425-257-8810 — FAX 425-257-8857 — www,everettwa.org <br />APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO d PM <br />SITE ADDRESS <br />5'119 RC)C KER FE C C t� <br />LEGAL LOT N0. BLOCK <br />DESC. � OO —r <br />TENANTNAME <br />PARCEL TAX I.D. J! <br />00 �{9 S8 c�0 � c� U C�00 <br />TRACT <br />L.AURE � N E= 6 t-} TS <br />(iRo�+EQS 39?.Z S��A�E..N�E ���Y���� <br />EU E Rf'�'7' <br />9f�2�S <br />CONTACT FOR PERMIT <br />Soe� �-tr�r�ck <br />CONTRACTOR � ADDRESS <br />HFlt�ck I3RUTNE(2S CONST. <br />CONTR. LICENSE # -392Z 8 7�QV E N�� <br />USE OF BUILDING <br />N Ew SF � <br />WORK DESCRIPTION <br />JJ E,W <br />,a�.�//-�-�,- <br />PERMITft <br />�/2S•3q7-7360 <br />PHONE <br />NZS-zyo - 2�2 9 <br />CITY2IP <br />EVEeETT <br />94�20� <br />I — HEATSOURCE <br />Eleclric � Gas Olher <br />� <br />S � 2 - �,Q/�t%21.v �C�S <br />NO. I NpE OF FIXTURE OR ITEM <br />I OIICI <br />BathWb <br />Lavatory (wash basin) <br />Showcr <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washcr <br />Water heater <br />Sink (service/badmop/etc.) <br />Back(low prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />O!her <br />PHONE <br />yLS• 397-7360 <br />CONTRACT PRICE OF WORK <br />125 K <br />N0. I TYpE OF FIXTURE OR ITEM <br />fvc – air handling units <br />.1_, Forced air systems <br />� Gas pipin� <br />L Water heater <br />1 Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhaust fan <br />Heat pump <br />Unit hea!er <br />_ Boilcr <br />Refr,geralion <br />_ Woodstove <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I here6y cerilify Ihat I have read and examined this applicalion and know the same lo be true and correct. All provisions of laws and <br />ordinaces governing ihis type of work will be complied wilh whether specified herein or noL The granling of a permil does not presume <br />lo give aulhonty lo violate or cancel the provision of any other slale or local law regulaling conslruclion or ihe periormance of <br />construction. hat I am authorized b the owner of lhis propeily lo perform lhe work for which application is made and I comply with the <br />State onlra��s Law 1827�RCW ar�1 �9Si,200 WAC. <br />