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11 <br />—�' _ e� <br />.; $ <br />PERMIT APPLICA�'ION <br />CITY OF EVERETT PERFAI� 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 - DEBIT 3 CREDIT CARD5 ARE NOT ACCEPTEC <br />SITE ADDRESS �C�'/ SSt� S«� PqRCEL TAX I.D. # p6RM�X <br />�d�,� E-rr �w,�l 9 � �v.3 � � 34�b� c�ex� � S"o z. � � � _ � <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />--.3'v��E (�en,u�tidcz <br />TENANiNAME <br />CONTRACTOR . <br />CIJ EN�" C f1f`/�F9 ( .� <br />CONiR.LICENSEM � <br />� �[�%l. �l.'�-; <br />USE OF BUILDING <br />i�c-�::1 cic--+t-�rr�� <br />WORK DESCRIPTION <br />55 P�- Si.c! c-�/c�een- �;t�S� 3 y�- / 2 9 2 <br />ICONTACiPOR PERMIT <br />PHONE �u,K ��_ <br />'�i <br />AODRESS C�ITY21P PHONE <br />���V• �1�� S�c✓��,.+/�, w�+ y��-J- 3bo,Nszl• <br />_�-i/��(// i:.�i, Y �JC C' <-+�%F`T' � <br />NO. I TYPE OF FI%TURE OR ITEM <br />'/_ ToIIBI <br />/_ BathWb <br />1 . Lavatory (e�ash basin) <br />Shower <br />L IGlchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />Laundry tray <br />Sink (servicelbarlmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrap <br />Roof drains <br />Other <br />— HEAT SOURCE iV CONTRACT PRICE OF WORK <br />� Eledric Gas Other I <br />,� � �— % ' <br />� ' � � /� �� ' �— C//GG,'' J � !i'. _ <br />� �G:��,uLi � l.l,lr ceCcGl�v , <br />NO. � TYPE OF FIXTURE OR ITEM <br />AIG — a�r handhruJ unils <br />Forced air systems <br />Gas piping <br />Water hoaler <br />Gas fireplace <br />Gasrange <br />Cbthes dryer <br />Range haod <br />Exhaust fan <br />Heat pump <br />Unit hea[er <br />Baler <br />Refigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7A)( COOE IS 3105 <br />I hereby cerilify lhal I have read and examined ihis application and know the same to be lrue and cortecl. All provisions of laws and <br />ordinaces governing �his lypu of work will be complied wilh whetl�er specified herei� w nol. The granting of a permit does nol presume <br />lo give aulhonty In violale or cancnl tha provision of any other stale a local law regulating construclion or lhe perfortnancs of <br />conslruction. Thal I a uthorized by the owner of ihis property lo peAortn the xrork for which application is made and I a�mply with the <br />Slale Conlraclors La 8. 7 RCW and 296.200 WAC. <br />� J�i,A / L•��G�� <br />�Z <br />� <br />