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SITE ADDRESS <br />'�7.(�/ i��,,c�� - <br />LEGAL LOT N0. <br />DESC. ,(( <br />OWNER <br />,z�"' � f.r .`�^ n G C!,� <br />TENANTNAME <br />CONTRACTOR <br />- I. Il.� V�uY�"�, <br />CONTR. LICENSE N <br />USE OF BUILDING <br />, <br />l�fr'�r �c,�%;� <br />P�RMIT APPLICATIUN <br />CITY OF EVEREI�T PERMIT SERVICES <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />�S9k�iiDtisr4�f?r10 <br />�lv�w� i Cr�� t , V �3, �"�O <br />Pp, /.:;0'�!9/I �'vr�r�;t Wf� �'A'Ana <br />r"'��-7�cr <br />CONTACT FOR PERMIT <br />i��(.UP--'✓`i <br />ADDRESS CITY2IP <br />HEAT SOURCE I <br />_ E�ecdic � Gas i Olher <br />-aS-oG <br />2MIT A <br />(v09- <br />�P'.�5•.75� /ti'� � <br />PHONE <br />PHONE <br />CONTRACT PRICE OF WORK <br />"��OOU * <br />WORK DESCRIPTION � <br />� r <br />/;�,:�.,,�, ,_/;<- !.vi/.�,' C�l�r rt.�iaic n,. N, sir�c' v7 e-��ciq, rt��r.�.�c� <br />�� / � .� _ � r <br />/"�!"I/IrrlC^/ ri . ' i� i: .r'r, .,:;.. � ._ ".iY; �' ��i .r✓7'i�,ii%;3 <br />NO. I TYPE OF FIXTURE OR ITEM <br />/ Toilel <br />_L Balhtub <br />Lavatory (wash basin) <br />� Shower <br />�L Kitchen sink 8 disposal <br />_,_ Dishwasher <br />J_ Clothes washer <br />Water healer <br />Sink (service/bar/mop/elc.) <br />Backflow provenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Olher <br />NO. � TYPE OF FIXTURE OR ITEM <br />AIC — air handling units <br />Forced air syslems <br />Gas piping <br />Water hea':r <br />Gas fireplace <br />Gas range <br />� Clothes dryer <br />� Range hood <br />,�� Exhausl fan <br />Heal pump <br />� Unit healer <br />Boiler <br />� Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby ceritify that I have read and examined Ihis application and know the same to be true and correct. All provisions ot laws and <br />ordinaces governing lhis lype ol work will be complied wilh whelher specified herein or noL The granling of a permil does nol presumc <br />to givo aulhority to violale or cancel Ihe provision o( any other slale or local law regulating construclion or the pedormance oi <br />construction. Th�l � am authorized by the owner of lhis property to perform the work tor which application is made and I comply with the <br />Stale Conir�..eN� Le'N 18.27 RCW and 29G.200 WAC. <br />`�r,� ;' /�%�" <%•?�/••/IL <br />'�Z <br />