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SITE ADDRESS <br />�"1nb SEwN <br />LEGAL LOTNO. <br />oEsc 5z <br />PERMIi APP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wwv��.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />rlv� I Ob <br />BLOCK TRACT <br />900 p—o I r�+tP'' <br />PARCEL TAX I.C!. M <br />PERMIT • <br />.-, .%lle% _. G;- <br />Donl h*1D ✓�'�4a�t.� Cn� " 4"1� `�e�4t1�+-sT 1�/� E�E� �nA� 9f2�3 ZS 2f'C. <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />SA MF <br />T1.� �'�k-��"C s�o.��.3yyi <br />CONTRACTOR p�/t� �hIS�I ADDRESS / CITY2IP PHONE <br />�j�lJ a <br />CONTR.LICENSE� ON10C'R-5UD}'LWt1 I�O BO'r� IZ"j _M.MI(�TE-0� ��YDZ�s ��7'� Z?'�I <br />USE OF BUILDING <br />V-�51 O EN � <br />WORK DESCRIPTION <br />�Vv1o0EL fl*!t� Fti�p 11l o+.l <br />NO. I TYPE OF FIXTURE C�R ITEM <br />m <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kdchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (sen�ice/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Diinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURC� <br />� Electnc _ Gas Other <br />01� EK � STi �( G7 r'Esi v F•�! t,E <br />��CONTRACT PRICE OF WORK <br />�l�j fe� ,y; <br />i <br />HO. I TYPE OF FI%TURE OR ITEM <br />AIC — air handling units <br />Fon,ed air systems <br />�_ Gas piping <br />Water heater <br />Gas fireplace <br />� Gas range <br />_J__ Clothes dryer <br />� Rznge hood <br />1� Eahaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CI?V OF EVERETT LGCAL SALES TAX CODE IS �705 <br />' read a d ezamined ihis applicalion and know the same to b= true and cortect. All provisons of laws and <br />Ipe of o�will be complied wilh whelher specifed herein or not The granting of a permit does not presume <br />or ca I e provision of any other stale or local law regulating wnstruc6on or Ihe performance of <br />thori d i the owner of this property to perform the work for which application is made and I comply with the <br />27 W and�3ii200 WAC. <br />3• <br />� <br />L <br />} <br />