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SITE ADDRESS <br />PtRMIT APPLICATIOI� <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 />%/ �1.�� �l' .Sc <br />LOT NO. BLOCK <br />PARCEL TAX I.D. # <br />UCi 7N� �-� UC�c�C% ! .5 <br />TRACT <br />OWNER AD�RESS CITY/ZIP PHONE <br />C� I NLi � L ��l/�/ S /U ,O! �( :- sG Evrr��. �ri yu -,�y y- ,,� <br />TENANTNAME CONTACTFORPE MIT PHONE T— <br />I�?r�Y�.� �tMcc i r-r-- y 2� 7 �5-c„r/U,c/ <br />CONTRACTOR <br />�.�v o- n� , ;-� <br />CONTR. LICENSE N <br />USE OF BUILDING <br />L'��n 6G- J-1 fTG <br />ADDRESS <br />13.�f. Avc �ti1, <br />ILG�N <br />HEATSOURCE <br />_ [Icclric _ Gas _ Olher <br />PHONE <br />���s- �� ,� U �Uy <br />CONTRACT PRICE OF WORK <br />�� � � C�L� <br />WORK DESCRIPTION <br />�Ef'cRCr %yirYlN G�v%9'it� Jc�Vic:F F�J✓= /fi�`aS�� � �Y✓� <br />/Y' F TG� TZ% {�ti�_SC <br />PLUMBING <br />NO. I TYPE OF fIXTURE OR ITEM <br />� <br />Toilet <br />Balhtub <br />Lavatory (�vash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwashcr <br />Clolhes washer <br />Laundry lray <br />Sink (service/badmopletc.) <br />6ackflow preventer <br />Urinal <br />Drinking Fuuntain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other !.(.�?TC`��- .h� 2j/iCE <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas pipinc� <br />Waler heater <br />Gas lireplace <br />Gas ran�e <br />Clolhes dryer <br />Rangc hood <br />Exhausl (an <br />Heal pump <br />Unit heater <br />6oiler <br />Re(ric�eration <br />Woodslove <br />CIN OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same lo be true and correcL All provisions of laws and <br />ordinaces goveming this type o( work will be complied wilh whelher specified herein or noL The granling of a permil does not presume <br />lo give aulhonry lo violale or cancel lhe provision o( any olher state or local law regulatinc� construction or the performanr.e of <br />:onslruction. That I am aulhorized by Ihe owner of Ihis property lo periorm the work for which application is made and I wmply with the <br />Slate Cor�lractors Law 18 7 RCW 6.200 WAC. <br />,�-��Jl` `;;����� y—�I'1�,��i <br />