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SITE ADDRESS <br />5 P�� Gi,,� Tino,�� <br />LEGAL�OT NO. <br />DESC. <br />PERMiT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� _/ 7-Od <br />PARCEL TAX I.D. N PERMIT N <br />�1��� � -U� <br />BLOCK TRACT OR SU6UIVISION 11 <br />�."X=rl-Y' /7N�11��1 S�/�-G✓1'7ino�c �d�'.Pc`�i 3S•3-/�/ <br />TENANI" NAME � CONTACT FOR PERMIT PHONE <br />wrv�nnciuns�� �Si Cn.yNG. ^_"' <br />oZ7v:�s-/ <br />CONTR. LICENSE k S�vCOLi= /JSfl K <br />USE OF BUILDING <br />y GHQ G ri�C'AGGT <br />WORK DESCRIPTION L����T� <br />(.v00t� f-�A"�� w� T� <br />�.0 vur rnvno <br />iqdc".+�c' �Q/E�L/.vYTON 'S'L5-z3Z-z7c`I <br />:�f'zz3 <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />�ectric _ Gas _ Olher �� S� v <br />� ,.f-NS%/�LC LUY1G/P- <br />NSS /CCUF "� C`��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tuilet <br />Balhtub <br />Lav2tory (wash basinl <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (servicelbar/mop/elc.) <br />BackBow preventer <br />Urinal <br />Drinkmp Fountain <br />Floor drain <br />Greaselrap <br />Rooi drains <br />Uther <br />/,t M=a��o��rrN�- S/�s <br />/200 F- Z- F�r ��C o2 ;� <br />/ <br />2 c s4 Q C1 /`t%'.t��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC - air handling unils <br />Ferced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslian <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />s t <br />i rereby ceritify Iha1 I have read and examined Ihis ap�lication and know the same to be true and conecl All provisions oi laws and <br />ordinaces goveminy this type of work will be complied with whether speci(ied herein or nol. The yranting o( 2 permit does nol presume <br />lo give authoriry to violate or cancel the provision of any olher slate or local law regulating construction or the periormance of <br />conslructio�That I am �aul ized Lyy lhe qrGner of this property lo perlorm the work for which applicalion is made and I comply wifh the <br />:,t2le Cont p(ors La�v 18. G�V ,�nd��"s.zoo wac. i , <br />/ <br />G <br />