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P���MIT APPLICATIO�J <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8N10 - FAX 425-257-8857 - www.everettwa.org c�` -�l � r` <br />-r <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED I <br />SITE ADDRE55 <br />v � zg r�� ���. <br />LEGA LOT NO. <br />DESC. <br />�L <br />BLOCK <br />SA�Fa�...t•� /371 o�k� <br />TENANTNAME <br />s'T� r b � �/� 5 <br />CONTRACTOR ��rr,, NCuaJ Co <br />CONTR.LICENSE# ��rr>, n,cc %7c �h <br />USE OF BUILDING <br />STtJ�'L <br />PARCEL TAX I.D. f� <br />OnS 8z I o 1 4of �oo <br />TRACT <br />.!� /3 C t.Q c✓ nG n�-f- cr.< /� <br />ICON7ACTFORPERMIT <br />s-/-�„t ,��0�7 r, yzs = <br />ADORESS CITY2IP <br />7yoo /i�f�.��Sc.aJ �J <br />�V�v� {/� Cv4" lIC2 0 i <br />HEATSOURCE I <br />_ Electric _ Gas _ Other <br />-�� <br />C <br />rnunc <br />7 76 - b'" g3 S"- <br />PHONE <br />�/ls- 7��•- 88' as- <br />CONTRACT PRICE Of WORK <br />$ � �UO ��� <br />� <br />WORKDESCRIPTION j„��.�q�� C/) Sr-� ur' �� {,✓ c�{,�r� l �� �fe-S � Cr� <br />h'�oe�v L � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & dispo�al <br />�ishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />I _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/G - air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refngeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA7( CODE IS 3105 <br />I hereby ceritiy ihat I have read and examined this application and know the same to be true and coRect. All provisions of Iaws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />ro give authonty to violate or cancel the provision of any other state or local law regulating construction or the pertortnance of <br />construction. That I am authorized�yy the ow r of this property to perform the work for which application is made and I comply with the <br />State Contractors Lav,c.A8.2i,RCCy� 6.� WAC. <br />, /� -� y <br />� <br />i� <br />