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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 - ww�:�.everettwa.org <br />��/��� �,�1� L� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />cironnnoESS PARCELTAXI.D.tt G��+9-�ZI <br />3`!� �Wfci-a�oR� a�� cnKa69-gz�-ow-eo � <br />3�-oa—o� <br />PFDMIT # <br />C���o� " �% <br />LEGA LOT NO. 8 OCK TRACT . " <br />DESC. \�,15, lb i �Z 1 �l�t o� �Uk:e�.TT fl�iltsioN A�� ��3 �(01 <br />S�M \ A1LTNlaRS <br />TENANTNAME <br />I.Z O N'r- <br />�S13o- R Cp,�q�ny c.l.�B 02 <br />COPITACT FOR PERMIT <br />M��� To�P <br />CONTRACTOR <br />ajTAQ ��'� CcanTQ SJ�1L <br />CONTR. LICENSE # <br />STr�atz c�aG�l 1��� <br />USE OF BUILDING <br />a�„h,r�.�r�A�. t,;� <br />WORK DESCRIPTION <br />�o►�S�a�� �a) <br />5 R'�. W�rz-I� <br />ADDRESS <br />Q. e.OoX �b39 <br />cinrziP Pno+�.LS.�S'f-B38o <br />i�lAld- CR�kk WA 4g012 <br />PHONE <br />�zs-�Sy-83 8 n <br />CITYIZIP . I PHONE <br />SIn1SOI�tOM�Sh y2�i-?$�'g�JQO <br />co,�,acr P��-s�a c`►�wc�-"i'op� <br />HEAT SOURCE � CONTRACT PRICE OF WORK <br />� (,J�,�(�yl � [leclric _ Gas _ Other <br />,., .. t. � �,,..;, ti-^v'-�_ . <br />Tw o--T2, �, a �;�.�:�..� 5 <br />=ac��dY,.y (.a.ns�n�,...�.� <br />TVPE OF FIXTURE OR ITEM11 <br />Toilet "� <br />Bathlub � <br />Lavalory (wash basin) � <br />Showcr 1 <br />_ _ �Kitchen sink & disposal I <br />_ Dts�iwasher 1 <br />_ Clolhes washcr � <br />_ Waler IiBater � <br />= Sink (service/bar/mop/etc <br />_ eacknow nreve�te� <br />Urinal \ <br />Drinkin� Poimlain �� <br />f loor drain <br />Grease Irap <br />Roof drains <br />Other <br />� 523, o�v <br />R�o R�.�re�n <br />3d�� i Z�3 <br />t' � NPE OF FIXTURE OR ITEM <br />_ VC - air handling unils <br />=orced air syslems <br />Gas piping <br />Water healer <br />Ges lireplace <br />Gas rarlgo <br />Cblhes dryor, � <br />Range hood � -`�, <br />Exhausl fan �' � <br />Heat pump 6� ` <br />Unil healer <br />_ Boiler <br />Refrigeration <br />� Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify thal I!iave read and oxamined lhis apptication and know the same to be true and correcL All provisions o( laws and <br />ordinaces goveming Ihis type o( �vork will be complied with whelher specified herei�i or not. The granting of a permit does nol presume <br />lo give aulhorily lo violale or cancel Ihe provision o( any olher state or local law regulatmg consWclion ur the pedormance o( <br />construclion. That I am authorized by Iho owner of lhis property to perform Ihe work for �vhich applicalion is made and I comply with ihe <br />Stale Conlractors La++-4$27 RCW and 296.200 WAC. <br />`� o o° � � , ,�� . � '�lz <br />