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SITE ADDRESS <br />LEGALI LOT NO. <br />DESC.r ,J <br />TENANT NAME <br />-�ONiRACTOg <br />, <br />` � J •�. �, <br />CONTR. LICENSE # l� . <br />J � J�i <br />USE OF BUILDING <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVECES <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 70 4 PM l� — l9 ` <br />,�j L.% <br />y:M � <br />�%7 <br />PARCEL TAX I.D. # <br />TRACT OR�SUBDIYISICN A <br />. i,ro /-�n�.:�.� � <br />��� <br />PERMIT # <br />, oa _c�(���07 <br />, , <br />r'�7 �X i�?%7k� �'%// �n�� w� yf�o�� <br />CONTACT FOR PERMlT <br />4>�l�x�ia��� <br />�rl.'l/ �'��� <br />iF1o�a <br />PHONE <br />E-MAIL <br />ya5-:,�vy �s�5/9 <br />I HEAT SOURCE CONTRACT PRICE OF WVKK <br />r, . -� <br />��"j _Electrick Gas_Other /�3cY70 <br />WORK DESCRIPTION <br />� .� � j :; u <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />_i Toilet <br />�Bathlub <br />Lavatory (wash basin) <br />_� Shower <br />� Kilchen sink & disposal <br />� Dishwasher <br />r Clothes washer <br />Y�,,� Water healer <br />_� Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />� „ , �U,� <br />� �{.s.� i_� <br />!✓ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />r Forced air systems <br />Gas piping <br />� / Water heater <br />/ Gas fireplace <br />T Gas range <br />/ Clothes dryer <br />% Range hood <br />� Exhaust han <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� hereby cerlify Ihat � have read and examined this application and knnw lhe same to be true and correct. All provisions of laws and <br />ordinances gover ing this lype of work will be complied with whather specifed herein or not. The granting of a permit does not presume <br />lo give authority t� violate or cancel the provision of any other state or Iocai law regulating wnstruction or the performance of <br />construction. That I am author{�ed by the owner of this property to perform the work for which appiication is made and I comply with the <br />Stale Conlractors Law 837 RC4U and•296.200 WAC. <br />i � / /� <br />/ ..''—} � <br />,�'i„�. i� /.sl;'L���' � /`J / i <br />�� 3��i � � <br />