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¢� � <br />circ nnnoESS <br />LOT NO. <br />�N,15� lb <br />PE�MIT APPLICATIOI� <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 />3 --o y -v 7 <br />APPLICATIONS ARE ACC=PTED FROM 8 AM TO 4 PNI � � <br />,� C ._, � �_ - � I (i= <br />PARCEL TAX I.D. q o�764-E21 •�� ' I o� � <br />QJ� cn'-1364-g21-AW-eo 'k _ ��Q;� �-(l�7 <br />�8 OCK TRACT � <br />Z 1 ���T o� �ukc�h.1T ��'vtsioN �i'� , lj3 � (01 <br />S�M IA�TNkUzs �S13o- R Cp,��y G.�B Oe <br />TENANT NAME CONTACT FOR PERMIT <br />tJON�— M��� To3�D <br />C� AAQC.TO_R ,. � ADDRESS tb3 1 <br />�oE�..y Co.nTQ'S�NC, Q,e.OoX <br />�nvur rn��.'Jc.`{��-j�:l <br />49A�u. ca.a� wp. aao�Z <br />PHONE <br />�{ZS-�S�{-83 8 a <br />CITY/ZIP , PHONE <br />s�.Noko��sl, y2s-�sy-83Q o <br />CONTR. LICENSE JI <br />4T�2�2c�qG�I KH eoa.rrRcx Pwa-soa t�n�Krr.TopD <br />USE OF BUILDING <br />2C'�i�����.TrcAL �.lUlb.c <br />WORK DESCRIPTION <br />�oNS,R�� �a) <br />S CC'dc W�2lf� <br />Tw o =� <br />TNLLUc�w l <br />TYPE OF FIXTURE OR ITEM <br />TOilel'',� <br />�athtub � <br />Lavatory (wash basin) � <br />Shower � <br />ilchen sink 8 disposal � <br />D nvasher l <br />Clol washcr � <br />Waterh ler � <br />Sink (servic �ar/mop/elc.) <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />H[ATSOURCE <br />� Eteclric _ Gas _ Olher <br />�...�� ,y, <br />�R.z-,-H�, (��i�d�-.�S <br />�.Wi,oscn� `�-y <br />t' <br />CONTRACT PRICE OF WORK <br />� 523� oo� <br />Ruo R�c,�r�a� <br />3a�� r z�3 <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />_ VC – air handling units <br />Poroed air systems <br />Gas piping <br />M(aler heater <br />Gas ra <br />Clothes d <br />Range hood � <br />Exhaust tan <br />Hoat pump � <br />Unit healer <br />— Boiler <br />• Rofrigeralion <br />� Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify Ihal I have read and examined Ihis application and know the same to be true and cortecL All provisions of laws and <br />ordinaces goveming !his type ol work will be complied wilh whelher specified horoin or not. The grantinc� of a permit does not presumo <br />to give authonty to violale or cancel Ihe provision o( any other slate or local law regulating conslruction or the performance of <br />construclion. That I am authorized by Iho owner of this property to perform tha work tor which application is made and 1 comply with ihe <br />Slate Conlractors Ly�'� 27 RCW and 296200 VJAC. <br />!� . l 1 � 'l� n n . n � I <br />0 � � ( <br />/ .+ /� �-` 1 � � � c, <br />J` <br />