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l <br />PtRMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVI �ES <br />3200 CEDAR STREET, EVERETT, WA 982U1 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />7c�8� V�Ft���ore C�vev <br />L[GAL LOT Y0. BLOCK <br />��dc� �i���tre <br />TENANTNAME <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />i��e � sc hi�n ��d GvP fi�zvr <br />N/A <br />wnircw��t�n qC?"�l �iPR(�nq <br />�A/'CLJ O` <br />CONTR. LICENSE M .� (, h ����y�� <br />% /i /"C(� <br />CONiACT FOR PERMIi <br />ti.{a. c-y <br />PERMIT � <br />M rf�b �l �033 <br />.EP�� q��oi �l��-a5a-� <br />PHONE <br />fv/�yl�ia7 `�l�P/7 <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />��.�1� �z'iMely ��,�Pi��r�� _Electric � Gas_Olher ��'7�O��C' � <br />i <br />WORK DESCRIPTION <br />��L'�"7V['i fa'i7 /�r}Y� CiiL % 4rC�s ������; /Vr�v�.,n!_. r /�,N�r=�— <br />�J <br />� i� S-frr lCr-� />� N�SF. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Ba1hWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />pJC — air handling unils <br />Eorced air systems <br />Gas piping <br />Waler hoater <br />�as fireplace <br />Gas rango <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refric�eration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilily ihat I have read and ezamined Ihis application and know lhe same to be true and cortect. All provisions of laws and <br />ordinaces �overning ihis lype ot work will be complied with whether specified herein or nol. The granting of a permit does not presume <br />to �ive aulhorily to violate or cancel lhe provision of any olher state or local law regulaling construction or the peAormance of <br />conslruction. Thal I am authorized by the owner of this property to perlorm the work for which applicalion is made and I comply wilh the <br />Slate Contraclors Law 18.27 RCW and 29fi.200 WAC. <br />�-.�2�-0� <br />