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S�TE ADDRESS <br />�? �G <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />'R D L I �1/-� <br />TENANTNAME <br />N/f� <br />C N A R <br />P�tRMIT APPLICATI(.�� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Su n c-r{- Ln <br />BLOCK <br />E� <br />CONTR. LICENSE N ���J <br />USE OF BUILDING <br />.-��" � i'�11��< ��.; V°1l <br />WORK DESCRIPTION <br />�.� ..�� I -1 <br />i.z''� <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION N <br />�210_ Sun�e} �n <br />� CONTACT FOR PERMIT <br />t,�e,-c�} u/,� 9baua 4as- a 2o���(I <br />PHONE <br />HEATSOURCE <br />��� S. / Electric _ Gas ��- Iher <br />CONTRACT PRICE OF WORK <br />`Sl.z7S�'U,L'� <br />� � ry'i ��l IcN-�� i 71;.rrti�� IAII �1�ib`�1."�J— C�f�Cc�n l.� �'C� <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilel <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />I<itchen sinh & disposal <br />Dishwasher <br />Clolhes washer <br />Waler heater <br />Sink (service/badmop/elc.) <br />Back(low prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greaselrap <br />Rool drains <br />Olhcr <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling uNts <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhausttan <br />Heat pump <br />Unit hcatcr <br />Boiler <br />Refrigeration <br />Woodsrove <br />Olher <br />CITY OF EVERETT LOCAL SALF.S TAX CODE IS 3105 <br />I hereby cerili(y lhat I have read and examined lhis application and know the same lo be true and correcL All provisions of laws and <br />ordinaces goveminc� this lype ol work will be com�Jied with whether specified herein or noL The granting o( a permit does nol presume <br />to give authoriry to violate or cancel the provision o( any other slate or local law regulating construclion or the per(ormance of <br />conslruclion. Tl�al I am authorized by Ihe owner o1 this property to perform the work for which application is made and I comply wilh lhe <br />Slale on ractors Law 1827 RCIN and 296.2001NAC. <br />(,� �/1 3�III� <br />Signa�urc ol OwnedConl . clodAut <br />I — -- — <br />