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SITE ADDRESS <br />1510 5� <br />LEGA� <br />TENANT <br />CONTR. LICENSE i!� � <br />--�--,f7 <br />USE OF BUILDING <br />1�C'TA1L <br />PERMIT APPLICATION <br />CITY OF EVEREI�'T 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 B AM TO 4 PM <br />PARCEL TAX I.D. N <br />BLOCK I TRACT OR SUBDIVISION N <br />CONTACTFORPERMR <br />DAwb �czgeti; <br />� J/2s�a <br />HEATSOURCE <br />_ Electric � Gas _ Other <br />q --6 i� <br />��09��-�ir <br />PHONC L{ 2�j �f 2� <br />e�a� 9A� �D t� <br />K,Rxv�,�� w�. uz <br />a�034 <br />CONTRACT PRICE OF WORK <br />WORKDESCRIPTION ST�g �r� Fo�25A�l�tAR`� L�►JES, Ah10 ON� GR�RS£ IJAS"�E ���E <br />FOQ FviUR[ TE1�Eti%TS.STU3 1N MA�N WAT6QSERJ�CE Fo2 gV�LOItJC7• <br />pLUM� UNE F�Oo(2 ORA1ti.i,A►�0 ON�. 5PRINKLER BLOI�J DO�Jti1 D'Rfa1►.1 1N <br />r�� e <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (servicelbar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />OtherFlRE SPR1q�lER <br />(�Lo�J DeUU 02Aiu <br />NO. I TYPE OF FUCTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl (an <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE �5 9105 <br />I hereby certify that I have read and examined this applicalion and know the same to be true and correct. All provisions of laws and <br />ordinances 9oveming this �ype of work will be complied wilh whether specified herein or not. The granling of a permit do , not presume <br />to give authority to violale or cancel the provision of any olher state or local law regulating construclion or the pedormance of <br />con ction. That I am authorized by lhe owner of Ihis property lo perform ihe work torwhich application is made and I comply with the <br />ta r ntractors L2N.18.2i RCW and 296.200 WAC. . <br />_UhBI <br />,Z � c <br />