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SITF ADURESS <br />/iio � 3�-� <br />LEGAL LOTNO. <br />PERMIT AP�LIC:'�TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />A25-257 8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. # <br />Y� a���/o00 <br />PERMIT # <br />rno�o�- <br />....��n .._"."' <br />vz.r. 3 7v. 98Yo <br />.Zi fJN l 2 ti r.�/ /// 0 7 3'� /�� SF CvB2 e7T 9& � Z R <br />7ENANTNAME I CONTACTFORPERMIT PHONE <br />��•�LV l3�oc:�3 2aG. 2S'J". 9/7i — <br />CONTRACTOR ULtoN ti-/Eill./ ADORE55 GIiY21P PMONE <br />4�/!y-Nw �t:R.e�/ L.�.fy Sr'M7zG 9�/u7 ZvL �712•.f',(Z2 <br />CONTR. LICENSE p <br />O�S /N <br />USE OF BUILDING <br />%zESiUt:uT; t}L_ <br />WORK DESCRIPTION <br />NO. I 7YPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 3 disposal <br />Dishwasher <br />Clothes washer <br />Loundry Iray <br />Sink (servic^fbadmop'etc.) <br />Backllow preveMer <br />Unnal <br />Dnnking fountain <br />Floor drain <br />Grease irep <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electric X Gas _ Other <br />CONTRACT PRICE OF WORK <br />.��ZOo dp <br />NO. I TYPE OF FIXTURE OR ITEM <br />_�+ NC – air handling units <br />L Forced air systems <br />L Gas piping <br />Waler heater <br />Gas fireplace <br />Gas ranc�e <br />Clolhes dryar <br />Range hood <br />Ezhaust fan <br />Heat pump <br />Unit healor <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TA7( CODE IS J105 <br />I hereby cen�ify that I have read and ezamined �his application and know the same lo be Irue and correct. All pmvisions of laws and <br />ordinaces goeeming Ihis type of work will bo wmplied with whelher specifed herein or noL The granling of a pertnit does not presume <br />to giv�� authorily Io violate or cancel Ihe provision of any other state or local law mgWating construction or lhe peAormance of <br />consiniclion. Thal I am authodzed by Ihe owner ol this property to pedortn lhe work for which applicalion is made and I comply wilh the <br />Stalc CoMracrors Law 18.27 RCW and 296.200 WAC. <br />3It <br />