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SITE <br />��t' <br />LOT NO. <br />PERMIT APPLICATIO�V <br />�ITY 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 />I PARCEL TAX I.D. il <br />�j� T�7 �.� S� <br />BLOCK TRACT OR SUBDIVISION # <br />�,:� �/ac /� <br />TENANTNAME <br />�j'`�'/l. - ��T//'� 5/' <br />CON7RAGIUR <br />�y /ai�c%tr S�r�is d 5�✓v�'�t <br />CONYR. LICENSE N <br />r=VL9ti�55��/Z��Z <br />USE OF BUILDING <br />/5 r' S <br />WORK DESCRIPTION <br />PERMIT # <br />�i,� v '�z}-- 3ss-z�s�`I <br />CONTACT FOR PERMIT <br />�� C��?� fi�� <br />�ooRess • <br />y �o / �i�riu'�.9� <br />'r��t-Ly `i `�fLO <br />HEATSOURCE <br />� Electric _ Gas _ Other <br />��al� �i����,� f�„-,�Q��. <br />PLUMBING <br />NO. I TYPE OF F�%TURE OR ITEM <br />Toilet <br />8alhlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (servicelbar/mopletc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />�_�_���-i�2 <br />yz �'-� s 9-z/�/ <br />CONTRACT PRICE OF WORK <br />�z 7��'`r <br />Np. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air sys�ems <br />Gas piping <br />1Naler heater <br />Gas fireplace <br />Gas range <br />Cloihes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healcr <br />�oiler <br />Refrigeration <br />Woodslove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify that I have read and examined this application and know lhe same to be true and correcl All provisions of laws and <br />ordinaces goveming lhis type of work will be complied wilh whether specified herein or noL The granling of a permit does nol presume <br />to give aulhonty to violale or cancel Ihe provision of any other state or local lavi regulaling conslruction or the performance of <br />conslruction. Thal I am authorized by Iho owner of lhis property to periorm the work for which appliwtion is made and I comply with lhe <br />Stal� Conlraclors Law 18.27 RCW and 296.200 WAC. <br />j— Z y -� cg` <br />Date <br />-----� <br />