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PERMIT APPLICATION <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 />SITE ADDRESS <br />.'0321 S Ln.two �� <br />LEGA LOTNO. BLOCK <br />DESC. .l''� _�. <br />OWNEH <br />R. ,1 � � ..� �-+J L-azarl�� G <br />TENANTNAME 1 <br />CONTR. LICENSE R <br />f�n� ti��i� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. N <br />G�Yo235c000c <br />TRACT OR SUBDIVISION N � <br />lzJ <br />CONTACT FOA PERMIT <br />S��O—o� <br />9MIT X <br />P/l%- �7� <br />PHONE'1 <br />-yZ5•75¢-Lyf.l <br />I D4V�D LA+LorIf.�L E-MNL <br />HhAT50URCE <br />X Electric _ Gas _ Olher <br />CONTRACT PRICE OF WORK <br />'i'�� /��,�i - <br />Zo �x 3� aPo�Tur�l`i'o �x�slinlb 2�w�1b��t� lo �n1c.L.��� � anD. �.�'Tk.i.�ow1 <br />NO. I TYPE OF Fl%TURE OR ITEM <br />� Toile� <br />'� Bathlub <br />� Lavnlory (wash basin) <br />� Shower <br />_ Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />waler heater <br />� Sink (service/bar/mop/cic.) <br />Backllow preventer <br />Urinai <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Rool drains <br />_ Olher <br />NO. I TVPE OF FIXTURE OR ITEM <br />ac - alr handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas lireptace <br />Gas range <br />Clothes dryer <br />Range hood <br />I Exhaust lan <br />Hea� pump <br />._,� Unit hea�er <br />Boiler <br />Relrigeration <br />Woodstove <br />Other <br />CITY OF EVEHETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify Ihat I have read and examined Ihis applicalion and know the same to be true and correct. AI� provisions of laws and <br />ordinaces governing Ihis type ol work will be complied with whether specified herein or not. The granting ol a permit does not presume <br />�o give aulhority to violate or cance� ihe provision ol any other sta�e or local law regulating construc�ion or Ihe perlormance of <br />construclion. Thal i am authorized by ihe owner ol Ihis propeAy to peAorm �he work lor which applicalion is made and I comply with lhe <br />Slale Conlraclors Law 18.271jFW ,and 296200 WAC. <br />� - <br />��.�s 1 <br />