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PtRMIT APPLICATIG�� <br />CITY OF EVERETT PERMIT SERVICES <br />320D CEDAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />51TE ADDRESS �7 � fj,�7�+ I <br />�`�US' � �l.cS�vc l�t.�-< <br />LEGAL LO'f N0. BLOCK <br />PARCEL TAX I.D. N <br />TRACT OR SUBDIVISION p <br />6 -a 3 -�v <br />P RMIT N <br />J /Oo�-D/7 <br />�rvntn auune�� �i�rrcir rnvnc— cf,Z� 3�� <br />�l cs <{`�,. LL�e � C�,/Cxi � 1��c vs-o PL� /-t S e v� 3�U6' f2�v�l4n. �tu J`��2?j (�Y>'� <br />TENANTNAME C TA TFORPERMiT(� ���5�,�7U P'RD�C � <br />���. (.t%�t�G�. Ti7l.r. ELC'iiLa/iy5'..�, <br />E-MAIL <br />R � A D ES 1/ZI��AaN� <br />CONTR.LICENSE7! VGU/tA��'� <br />USE OF BUILDING <br />(7Ll�I �x <br />HEATSOURCE <br />�, Eledric _ Gas ___ Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION(?) / l�,cn. .(�.� �.r,.�L.`.�Q �?LlJ�-u�r, f.�&,(.(', (9-L�c.uc.t-�, �% z C.�.H,,,E.''_, <br />,t� �.n_.cQ� [,cSl/t�� s,,.�.�. LL,�sEti,,,,v�, ,.,s, �cc.,c �, i+M-�p�+-^� c'p'tSl-�-� t v,�„t�f:. /i�cvi �-�4)-�l/ <br />., o`^--f � ( . �i:u r.�ecti1� Y ��,-r.�. �3� i� �«� 3: r."^'-.� . : � f-`",,.-� o"wf l � , <br />'-- <br />NO. <br />� <br />� <br />� <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />13athtub <br />Lava�ory (wash basin) <br />Shower <br />Kdchen sink & disposal . <br />Dish�.vasher <br />Clothes washcr <br />Waler hea�er <br />Sink (sen�ice;badmop/etc.) <br />Dack(low pieventcr <br />Urinal <br />Drinking Fountain <br />Flooi drain ' <br />G�easelrap� <br />Roofdreins� ' ) �7 <br />Other I �v(,'�� �� (�Ln�'� i7.�u`v� - <br />�wfi � <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC - air handling unds <br />Porced air syslems <br />Gas pipmg <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />[xhaus� lan <br />Heat pump <br />Unit heater <br />�oiler <br />Relrigera�ion <br />Woodstove <br />Olher <br />C�TY OF EVERETT LOCAL SALES TAX CODE IS �f05 <br />I hereby certify iha� I have read and examined Ihis application and k.now Ihe same �o be Irue and correct. All provisions of laws and <br />ordmances goveming Ihis type ol woik �vill be complied with whether specified herein or not. The granling ol a permil does nol presume <br />to give authority lo violale or cancel the provision ol any olher slafe or local law regulating consiruction or ihe peiiormance ot <br />construction ihat I am 2uthorized by R�e owner ol ihis property to periorm ihe work lor which application is made 2nd I comply with lhe <br />Slale C Nraclors /L'd�v 1 P27 RCVV and 296200 WAC. <br />,--�� �L� L �; : /£ _-l��l'_. /o -l4'I r� <br />