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SITE ADDRESS � <br />��i�-T" 5 � <br />�ecn� �or No. <br />/I,�lz,s�' -. <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-6857 — www.everettwa.org <br />� <br />AFPL�CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />CONTR.LICENSEp W(+(_�- (�LO3�L`� <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION II <br />ADDRESS <br />�I(�'�` �{ S �l�' A�c. <br />CONTACTFORPERMIT <br />J�;��J .AC�4��.5 <br />i 73� � TyE sr. s� <br />HEATSOURCE <br />Electric Gas Othcr <br />PERMIT # <br />PI�CX'�-D� Q <br />CITYIZIP PHONE <br />��el �', r.�ac�3 <br />PHONE �s 3(�t� 7�i`i b<%ai <br />EaWAIL JtikQ •: ��F��c�w...��rcJ�ii � <br />c���tc.. 56a�� 3l� �Y �Gal <br />I CONTRACT PRICE OF WORK <br />WORKDESCRIPTION - 1-i1��`��� ��.v�l Jw1 I `�Ul�n� I�l ���I�Vh'� A"�cL-�can� In.t��2 d1�ln�h5 <br />F�, �,��,�� �;,,� ..�,�.� .,�„�,r; ,�,��„�, � �� .�.t,� �.t��,r. � <br />NO, I NPE OF FI%TURE OR ITEM <br />Toilet <br />�athtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen smk & disposal <br />Dishwasher <br />Clothes washer <br />Waier heater <br />Sink (service/bar/mopletc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other S�i�,T� ,m�� <br />NO. I TYPE OF FI%TURE OR ITEM <br />AiC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaus� fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3705 <br />I hereby certify that I have read and ezamined ihis application and know the same to be Vue and correct. All prowsions of laws and <br />ordmances govemmg this type of work will be complied with whether specified herein or noL The granting of a pertnd does not presume <br />to give auihorily to vlolate or cancel the provision of any other stale or local law regula6ng construction or the perfortnance of <br />consirucllon. Thal I am aulhorized by the owner of this propeny to pertorm ihe work for which appBcation is matle and I comply with the <br />State Contractors Law 1827 RCW and 296.200 WAC. <br />