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P�ERMIT APPLICATION <br />CITY OF EVERE'f"i' PERMIT SERVICES <br />3200 CEDAR S7R�ET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />SRE ADDRESS <br />2dol -tc.. sr <br />LEGA lOT N0. <br />DESC. <br />1✓�1�-l� �� ���' <br />TENANTNAME <br />�� <br />� A.vr,�c�v� l�e u-�,ric� <br />CONTR. LI ENSE N <br />USE OF BUILDING <br />l�� <br />WORK DESCRIpTION <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAIC I.D. if <br />SIOCK TRAC70RlUBDIVI910N� <br />AD RESS `— <br />� �DI SlZItG �'T 1 <br />CONTACTFORPERMIT <br />ja2z. g ��-u,�,�.q <br />s -/7 -/L� <br />PERMIT p <br />i c�S - � S <br />PMON <br />�,� uzs zs�so�. <br />NE u�J� ��.=��`7 <br />U(olU � � ..,..... YK�� <br />w�^�{U��'��� �. g 3- U2S'-2s2a <br />HEATSOURCE <br />V, Eloctrle � Gas _ �lher <br />j vl S`i�. � �� f�3P'"� 90. �j �'�/wl�P <br />N0. I TYPE OF FII(TURE OR ITEM <br />Bathlub <br />Lavatory (wash Dasln) <br />Shower <br />Kllchan sink 6 disposat <br />Diahwnehnr <br />Clothoa waehar <br />Walor heater <br />Sink (service/barlmop/etc.) <br />Backflow proventor <br />Udnal <br />Drinking Fountaln <br />Floor drofn <br />Gronsn trap <br />Roof dralns <br />Other <br />CONTRACT PRICB OF WORK <br />N0. I TYPF OF FO(TURE OR ITEM <br />� <br />AJC —air handllnp units <br />Forcod alr syslems <br />Gas pipinp <br />Water hoeter <br />Gns lir¢plyca <br />Gaa ranga <br />Clothoc dryor <br />Range hood <br />Exhnustfen <br />Haet pump <br />Unit hoaler <br />Bolier <br />Rnfdppratlon <br />woodslove <br />Ot�or <br />CITY OF EVERE7T LOCAL SALES TA7( CODE IS 7105 <br />I haraby ceritity lhat I heve read en0 oxamined ihls oppllcallon entl know Ihe same to bo W a and corcpC4 All provisians of laws and <br />ordlnacas poveming thls rypo ol work wlll bo compltod wllh whathor spoci�etl nerein or noL Tha pmntlnp of a Dermil 0oes not presume <br />to g��o autl�orlly to vlotate or canc pruvision ot any othor atAto or locat law roguiating consln�ctlon or the peAortnance of <br />cunatruction. Tliat I am aulhorl d by t ownor of lhl� proparty to peAorm lhe wark for which appllcaUon is made anJ I cumply with thy <br />Stnto ont� r. 2� c�nd 86.200 WAC. � � I� I�� <br />7�1'd L588L525cbT�01 �W021d Sb�i2 0L02-b-Nt1f <br />