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r— <br />SITE ADDRESS <br />98i y'``' O/ s� <br />LEGAL LOTNO. <br />DESC. <br />PERMIT APPLiCATION <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 />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />Pe 9 �1 ��. %r, c.� � � �/ `/ �` /J� 5�— ��,,1.c�/ <br />TENANT NA CONTACT FOR PERMIT <br />� �� I �N��yti,� (�i.�b.�� <br />CONiRACTORi, IASH�N�`r��J �V���� ADDRESS JjS.J, <br />V L <br />� tL � /Z'� <br />CONTR. LICENSE �l n <br />USE OF BUILDING <br />WORK DESCRIPTION <br />(�1an� <br />NIT tt <br />U�9 - 3Cv <br />., ,: <br />�o�Js�� �s� <br />PHONE `��r � <br />� <br />�� „� >> s' y5�'�' <br />�b':� 3 ,Y <br />�HEAT SOURCE � I CONTRACT PRICE OF WORK <br />Electnc _ Gas _ Other (p 7� <br />o� �� a�C.�� //� �iC�. <br />NO. I TYPE OF FI%NRE (`R ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/barlmop/etc.) <br />Backllow prevenler <br />Urinal <br />Drmking Founlain <br />Floor drain <br />Grease trap <br />Rool dr�in�G� 1- �{�l <br />� OUierW 1\.L <br />NO. I TYPE OF FIXNRE OR ITEM <br />wc — av nandiing unrts <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Cbthes dryer <br />Rangr.hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Rehigeration <br />Woodstove <br />_ Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby centity �hat I have read and ezamined ihls application and know the same to be true and conect. All provisions of laws and <br />ordinaces goveming this iype o( work will be complied with wliether specified herein or not. The grantiny of a permit does not presume <br />to give authority to violale or cancel ihe provision of any other state or local law regclating construdion or the performance of <br />consirucfion That 1 am auihonzed by the owner of Ihis property to perform the work for which app�ication is made and I compty with ihe <br />State Contractors Law 1827 RCW and 296200 WAC. <br />/��Z�^U 1- �3 �; <br />T <br />