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SITE ADDRESS <br />�93-T`z <br />LEGAL LOTNO. <br />5'�n r <br />F �RMIT APPLICATIUN <br />CITY QF EVERETT PERMIT 5ERVICES <br />3200 CEDAR STREET, EVERETT, WA 58101 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />��Fz2�'7�y <br />G1 <br />P MITl� <br />� ��/� <br />-35�1_ <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />1i��'H-n-' �Cu�r- 425•?75-(0�((0�% _ <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />t�R''(1-ill�E G'u-n6ird-`f'�Cr l(�6•/�/ �3.#i�A�•''�- L-vN�`'�°1"v� y�5_��5-Gy(��/ <br />CONTR. LICENSE # CJ�iU,3 / <br />Dil 4`�-L PH Dy � C6+�. <br />USE OF BUILDI�G I — HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric � Gas _ Other ���' Z(p. 33 <br />WORK DESCRIPTION <br />�EOI�GE C�ISnnJls G�S ��-n�.4CE u�i;'fl �/�tv <br />,� G�l-5 Fu2�✓.�� . <br />. --.— ----.... <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposa� <br />Dishwasher <br />Clothes washer <br />W ater heater <br />Sink (service/bar/mop/etcJ <br />Backflow prevenler <br />Ur?nal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I T1'FF OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forc�d air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranye hood <br />Exhaust fan <br />Healpump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y lhal I have read and ezar,iined this application and know the same to be lrue and correct. All provisions of laws and <br />ordinaces goveming this type of work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />to give aulhoriry to violate or cancel the provision of any ether stale or local law regulaling conslruction or lhe performance of <br />conslruclion. That I am aulhorizecl by lhe owner of this propeAy to perform lhe work for which application is made and I comply with the <br />Sta�r, Cor�lradors Law 18.7,7�RCVV and 29�6 °�4 V��AC. <br />��..�, ._ c,�l��.�%rl / J-Z�J-O% <br />