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P�RMIT APPLICATI�,�J <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 />SITE ADDRESS <br />�dbN 3�w0 yT <br />LEGAL LOT NO. <br />DESC. <br />S� G <br />TENANT NAME <br />CONTR. LICENSE # <br />USF OF BUILDING <br />� <br />WORK DESCRIPTION <br />V p i�/07 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,+ � I PARCEL TAX I.D. # <br />a+ nni�'iOn�li �nn /n'1 <br />BLOCK I TRACT OR SUBDIVISION # <br />ADDRESS <br />31�0 �'�acrer P� Av� <br />ICONTACT FOR PERMIT <br />7W G�kSwl�+7 <br />AODRE55 <br />312D G�p <br />I — HEATSOURCE <br />Eleclric � Gas _ Olher <br />3 %oW�'lv�'e <br />NO. � TYPE OF FIXTURE OR ITEM <br />Tailet <br />Bathtub <br />Lavalory (�vash basin) <br />Shower <br />Ki�r.hen sir�k 8 disposa! <br />Dishwasher <br />Clothes washer <br />Water heatr� <br />Sink (servicelbadmop/etc.) <br />Bar,kflow prevenler <br />Urinal <br />Drinking �ountain <br />Floor arain <br />Grease trap <br />Roof drains <br />Olher __ <br />F:3 <br />3�3-06 `� � <br />PHONE � 5�'0 / � y <br />� <br />E•MAIL JFfM1�GIDit97/H/6 <br />CONTRACT PRICE OF WORK <br />225,-aoo,o� <br />C j7a� <br />2%� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handlinc� unils <br />Forced air systems <br />Gas piping <br />W ater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Kange hood <br />Exhaustfan <br />Heat pump <br />Unit healar <br />Boiler <br />Refriyeralion `� <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby eerility that I hav� aad and examined this application and know the same lo be true and correct. All provisions of laws and <br />ordinaces govsminy lhis type o( work will Ue complied witl� whether speci(ied herein or not The granting cf a permil does nol presume <br />to givr, authority !o violate or canr.el the provision n! any other state or Iocal law regulating construction or the performance o( <br />conslruclion. Thal I am authorized by the owner of lhis properly to periorm the work for which applicalion is made and I comply wilh the <br />Slale Conlractors Law id.27 RCW and 296200 WAC. <br />SignaWre o( OwnedConUaclodAulhorized Agent Dale �I a <br />