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a25-757-1666 R✓�HEAi.NG <br />Ot �.51 �.44 p.m. 03-07-2014 7 �A <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.evereliwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADOFESS <br />� Zg Kl es� lii ew �+' <br />LEGA LOT N0. BLOCK <br />DESC. <br />OW ER <br />A,- lo n OW�ens by <br />TENMIT NAME <br />cm Qa nqinc- ��+�5 <br />`�"�pC`�v1 SF�T� 09 SR�F <br />USE OF BUILDING <br />PAflCEI TAX I.D. # <br />TflACT Op SUBOIVISION f <br />CONiACi FOR PEflMIT <br />C—�I CY'Ctf <br />HEATSOURCE <br />�Electdc _Gas_Other <br />PHONE <br />3�Ib`�� <br />PERMIT i! <br />i1� r NO3 - b �- <br />5 315 ?�8�- <br />�+Z5259�666 <br />CONTRACT PRICE OF WOPK <br />��, 6�� <br />WORK DESCHIPTION <br />1 n5-�0,� h2Du% � w+�D � P� �h� �P.1�, 5���� <br />N0. � TYPE OF Fl7C7URE OR REM <br />Tollet <br />Dathlub <br />Lavatory (wash bazin) <br />Shower <br />Kllchen slnk 8 disposal <br />Dlshwasher <br />Clothes washer <br />Walor hoaier <br />Sink (servico/bar/mop/atc.) <br />Backflow provonlot <br />Unnal <br />Drinking Fauntaln <br />Fioordraln <br />Graaso t�ap <br />Rool drains <br />'� O;her <br />NO. I TYPE OF FIXTUflE Oq ITEM <br />A/C — alr hdndling uNts <br />Farced elr systetna <br />` Gas plpin0 <br />Water healor <br />Gaz Ilraplace <br />Ges rango <br />Clollres dryer <br />Rango liood <br />Exhausl lan <br />= Heat pump <br />Unit healor <br />Bollor <br />P.efrlgemtlan <br />Woodsl ve <br />_L O:hcr�+r � � <br />� <br />CfTY OF EVERETT LOCFL SALESTAX CO�E IS 9705 <br />I hereby csdtity that I havo read and examined lhls appllcatlon anc kriow Ihe same lo be Irua and wrrect. All pmvlslons ol laws and <br />ordlnaces govorning this typo ol work wlll ha complied wilh wholhe r spacilled hereln or noL The granling al n permit doos nol presume <br />to glve authority to vlolale or cancol Iha provlslon ol any other slat�� or local law regutailnp construcllon or lho porformance ol <br />conslructlon. That I am eu�horized by Iho ovmer al Ihls pmpeny lo porlorm lho work lor whlch appllcatlon Is mnde and I comply wllh tho <br />Slate Conlraclors Law 18.27 RCW and 296.200 WAC. <br />I�hl��. 1�„oh,r .�, �,1.�}'_ <br />