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PE�CMIT APPLICATION <br />CITY OF EVERETT PERh11T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />AFPLICATIONS ARE ACCEPT. ED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />� �3�- w��� ,� A� <br />LEGAL LOT NO. BLOCK <br />oesc. j nn � .. <br />OWNER ��h <br />i,ARU) �, 7�4G0 1� S�/�-� <br />TENANTNAME <br />�'<L20 � GO �SCiL <br />CONraacTOR � 2 G M � R A� A <br />PARCEL TAX I.D. p <br />~�nninil�n <br />TRAG7 � � / <br />,C�� /�A���` i�F_f4�Ts <br />�� � ADDRESS r � CITY2IP <br />TAu5�3�•'L —GV�=_iMOR �VGRE/I�j/V�, <br />�.Iq `�!6 <br />.� — <br />� � - ;1p <br />3S3 -61_ 07 <br />CONTACT FOR PERMIT I � PNONE <br />�antr� a.Qs�M�a�tSa. �3�0�297-��32 <br />Hc.Hc-� 97- 7�� •'•_ <br />ADDRE55� <br />CONTR. LICENSE k pI F M� S.� qy�,v9 <br />USE OF BUILDING <br />� F h <br />WCRK DESCRIPTION <br />�10� ,;�f <br />OK �ly CITY2IP PHONF� CO'.Z9%—�,?,�' <br />Kin►7.cfeNjWA• <br />9go'S/6 <br />HEATSOURCE <br />� Electric _ Gas _ Other <br />CONTRACT PRICE OF W/�ORK <br />�(�� 0�0 :�a�ao�r,✓3 <br />,C��X :��� /i✓"nc� j'Jn.�C' � �j /K b / �%nti'��f� <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Oathtub <br />Lavalory (wash basin) <br />$�lOWOf <br />Kilclien sink 8 disposal <br />Dishwasher <br />Clothes washer <br />lNOlnf �1�3�Cf <br />Sink (servicelbar/moplelc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease irap <br />Rool drains <br />Olher <br />NO. I TYPE Of FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />VJ81Cf hCalef <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Ranae hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woods�ove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and cortecl. All provisions of laws and <br />ordinaces goveming lhis �ype o( riork will be complied wilh whether specilied herein or nol The grenting ot a pertnit does not presumo <br />lo c�ive au�hority lo violale or cancel the provision of any oiher state or local law regulaling construction or lhe performance of <br />constr ction. Thal I am •�uthorized by the owner ol Ihis property to perlorm the work for which application is made and I comply with Ihe <br />Stat Contreciors Law 18.27 RCW and 2�9 -�y0 WAC. <br />- .. �"�C C�1,.� G' �� �t���,. oc <br />�(L <br />