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SITE ADDRESS <br />I�Ib �hr-I�IL <br />LEGAL LOT N0. <br />oesc. 19't14R-N 2� <br />PERMIT APPLICATION <br />CITY OF EVERETi PERMIT SERVICES �`a"�'`o'6 <br />3200 CEDAR STREET, EVER[TT, WA 98201 l/`•C �� -�; �'� <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />!FV �IU� <br />I BLOCK <br />'� 37 <br />PARCEL 7AX I.D, p <br />y � 7g�o�qoo, 004�39 <br />TRACT <br />vow�nE 3 a� put7s , <br />aooaess nrvnin <br />�IK-sT #�hins�' �Ntit�H o� �vt�1T iblbY/�U�IL/�YE. <br />TENANTNAME <br />t��-r ��nsr <br />��J �Si/� c< <br />�q-z�) zy 1- 9 I bi <br />t _C�-N �.n �.ry� PHONE <br />�ril�c..�7��-�— �`�ZS)252—Z1S$ <br />CONTRACTOR ADDR[SS CITYlZIP PHONE <br />Cqh�f'�iJtY CnFiSTjtlAL7jq�J io�u i�rr+/,ve.h.��5uff�G� �V�'Tj" �4z5)b38-zl14 <br />CONTRLICENSEt /�.�C�NGLI��K,7) �$nivl <br />a�� 1 lJ�+'Tl <br />USE OF 6UILOING <br />CAMMNNri�j OIAjj2.��71GH <br />WORK DCSCRIPTION <br />IiGAT SOURCE <br />_ [ledrie � Gas _ Olhcr <br />Nbk/ 2���-13�,•� �ulL7�l�. <br />NO. I TYP[ Of FIXTUR[ OR ITEM <br />Toilcl <br />o�mw� <br />Lavatory (wash basin) <br />Showcr <br />KilGien sink & disposal <br />Dishwashcr <br />Clothes era;hcr <br />Laundry tray <br />Sink (servicc/bar�;.�op/cic.) <br />Uackflow prevenler <br />Urinai <br />Drinkin� Pountain <br />Floor drain <br />Grea;e trap <br />Roof drains <br />Olher <br />i <br />�� :Z�l� l� �� <br />�'�^ <br />% ' <br />;; ,�'t,., <br />- -�--- <br />CONTRACT PRICE OF WORK <br />� 3,9 c�o, c aD �� <br />i�: � �� )O <br />, �i/-'G3 �j <br />NO. I TYPE OF FI%TURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Walcn c�alcr <br />Gas fimplacc <br />Gas rangc <br />Clothr.s drycr <br />Range hood <br />[xhaust 1an <br />Heal pump <br />Unit heaMr <br />Ooiler <br />Refngeralion <br />Woodstovc <br />CITI' OF [VGR[TT LOCAL SAL[S TA%COD[ IS J105 <br />/ <br />r l ; <br />I hemby ceritify that I hove read and examined Ihis applicalion and know Ihe same to be true and correct. All provisions of laws and <br />ordinaces govemin� this type o( worA �dll be complied v.ith rdiethcr spedfied herein or noL The granting of a pemiit does not presume <br />lo �ive aulhonty to riolole or cana�l the provision of any other sWta or Iocai law regulaling eonsWdion or the pedortnana: of <br />constructio�. That I am auth rized t e o:mer of Ihis property lo pedorm ihe work for vAiich apptication is made and I comply v:ith the <br />SWIe CoN �7Xiurs Law,18. '2C an 296,200 WAC. <br />I �• Z3'��.5 <br />�/L <br />