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SITE ADDRESS <br />240� ss <br />LEGAL LOT NO. <br />DESC. � S <br />PcFtM�T 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 Ai2E ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAl( I.D. # �RMIT # <br />'=�'s�-. S•cJ. oo$/3Soodvlo$acyv�� (�,�o -33 <br />BLOCK TRACT <br />l7� Q �U lC.i <br />G—?/ . <br />TENANTNAM <br />T e SR �-�- �=—' <br />CONTRACTOR <br />COkTR. UCENSE # <br />�lZ/Z�( �� <br />CONTACT FOR PERMIT <br />Gar+e. <br />� CU � L-' %�Z, <br />USE OF BUILDING <br />r2 �-s. <br />WORK DESCRIPTION <br />ADDRESS <br />�.�;[L f�,�G�,l(ar,ds IJ-'✓•�z <br />�2, ��r <br />Cprr+ e�.5e+t <br />CITY2IP <br />HEAT SOURCE <br />_ Electric _ G�s __ Other <br />�/�7�J f,��-� Ci4n,�'-�ton -�b <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />Kitchen sink & disposal <br />_ Dishwasher <br />_ Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backilow prevenler <br />_ Urinal <br />_ Drinking Founlair� <br />_ Floor drain <br />Grease trap <br />=Roof drains / <br />Other <br />S.w. <br />PHONE <br />r��3� 74'4/ <br />CCNTRACfPRICE OF W�RK <br />nt4� (a 43d <br />{�uu,s� �eek.) <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems / <br />Gas piping <br />W ater healer <br />Gas fireplace / <br />Gasrange �J, <br />Clothes dryer �/ <br />Range hood � <br />Exhaustfan ` <br />Heat pump v <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same lo be true and correcl All provisions of laws and <br />ordinaces governing this type of work will be complied wilh whelher specifed harein or not. The grantiny of a Ferr�il does not presume <br />to give authurity to violale or cancel the provision of any olher state or local law regulating construclion or lhe per(ormance of <br />construclion. Thal I am authorized by th wner of this propery lo perform the work tor which application is made and I comply with lhe <br />State Contraa�ors Law 18.27 R�J a�6.200 WAC. <br />�b-G-G? <br />