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P�RMIT APPLICATILN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �'VA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />� .��j —O � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />�S 3Z <br />LEGAL LOT N0. <br />DESC. <br />BLOCK I TRACT <br />PARCEL TAIC I.D. # <br />��/Cp�36v �b3/DU <br />--- <br />I1/ICcri� y�1 t^3' %ck�Y�'► 2532 S�cf� iuer� <br />TENANT NAME I CONTACT FOR PERMIT <br />L!/1��-- <br />CONTRACT R <br />Lu1�� /�1�7 <br />CON R. LI ENSE # <br />I.� �.r%%/r- <br />USE OF BUILDING <br />f �2 <br />�Q, 1 h <br />r„ „ � ADDRESS <br />dyy v <br />?-���� <br />CITY2IP <br />�-�Y�e 4� <br />��e, �4-,�a c , ��l `I � <br />PERMIT # <br />7 �� — <br />"3 s� �SsS <br />:� <br />r <br />PHONE �/� <br />.,o <br />�a-�2 dc� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Electnc � Gas _ Olher <br />WORK DESCRIPTION � <br />C��1 '�Z �ti1' ��4 cP C12� ��c <br />7c�, orx� f9fi.1 `I' <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fount2in <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />VJater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range huod <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refngeralion <br />1Voodstove <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby cerility that I have read and examined this application and know the same to be irue and correct. All provisions of laws and <br />ordinaces governinn this type of work will be complied with whether specified herein or not. The grarting of a permit does not presume <br />to give authonry to violata or cancel the provision ot any other state or !ocal law regulanng construction or the performance of <br />construction. That I am authorized by the owner ot this property to perform the work for which application is made and I comply with the <br />State C Clractors Law 7 RCW and 298�. Q0 WAC. -�/ <br />� i.. A �/ /_ /1 \ l�J/�...� � <br />