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,,,� P�RMiT APPLICATION <br />�� CITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-d810 - FAX 425-257-8857 - www,everettwa.org <br />SyZ ) r-�C� �2 �IC � APPLICATIONS ARE ACCEPTE� e=P.OM 8 AM TO d'rM <br />SITE ADDRESS <br />-�3�r-� sT. S, � <br />LEGAL LOTNO. BLOCK <br />DESC. "� ��—� <br />N�A�� t3Ro,-�►ces <br />TENANT�AME <br />PARCEL TAX I.D. # <br />Co��uS �UO�00 � 0 O <br />TRACT <br />L/�U�REI. HE'� C�N TS <br />3qaa g�+� a�r.N,E �vt <br />CONTRACTOR <br />NaAc.k t3ac•�NeRs Con�sT. <br />CONTR. LICENSE z <br />USE OF BUILDING <br />SF� <br />WORK DESCRIPTION <br />PJ Ew <br />PLJI <br />TYPE OF FIXTURE OR ITEM <br />:f <br />ilUb <br />atory (wash basin) <br />h'3f <br />ien sin�: & uisposal <br />washer <br />ies washer <br />:r heater <br />(service/bar.�mop/elc. ) <br />;flo�.v prev���� �r <br />31 <br /><ing Founta�r. <br />r drain <br />ise trap <br />d a�ns <br />r <br />CONTACT FOR PEP.MIT <br />Soe� N�,flck <br />ADJRESS � <br />39aa ��+-�AvE.N,E <br />I HEAT SOUFCE <br />ir x <br />%J ; <br />y25- 39�• 7360 <br />PHONE <br />tizs-ayo-ayaq <br />^ CIfY21P PHONE <br />E'vE4E'Z'T 42s-3Q���360 <br />98ao5 <br />_ Electric Y. Gas __ Olhr.r <br />SF� ��:1li %0.5 <br />CONTRAC � PRICF OF WORK <br />,25 r. <br />NO. � TYPE OF FIXTURE OR ITEM <br />�vc — au nantlling units <br />—1— Forced air systems <br />�_ Gas piping <br />�. W�ICf �1C2�Cf <br />�Gas fireplacc <br />Gas ranc�e <br />� Clolhes d��er <br />� Ran�e hood <br />3 Exhaust tan <br />Heat pump <br />Unil hea�er <br />Boiler <br />Re(rigerelion <br />Woods�ove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerility thal I have read and ezamined this appli:alion and kno�v Ihe same :o be irue and correcL All provisions o( laws and <br />ordinaces goveming ihis type o( work will be complied u:th whelh� � speci(ied herein or nol. l�he gran;ing of a permit does not presume <br />to �ive authority to violate or cancel Ihe provision of any other stale or �ocal law regulating consLtiction or the performance of <br />conslruction. That I am ;�thorized by the owner of this prop�rty to pertorm Ihe work for which applicalion is made and I comply with the <br />Sta�Contr�rs Law 18.27 �;��p0 WAC. I L <br />G-�0-0� <br />�L) <br />