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51TE ADDRESS <br />LOT N0. <br />JorJ/��-1�1APJ � <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.ev�rettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_, 5� <br />BLOCK <br />CONTRACTOR L��=JT%�f� CD• <br />GONTR.UCENSEp ��7-sr—C�,�� <br />c <br />USE OF BUILDING <br />WORK DESCRIPTION <br />IZ�PUtC� <br />5�T c�1J <br />bu� 5� <br />I� <br />PARCEL TAX I.D. p <br />2.SoSi `700305; <br />TRACT <br />ADDRESS <br />J Ilo IIoTH �+� ti <br />ONTACT FOR PERMIT <br />r`oi� c1�1P.iSi'IAfJS <br />AI7 # i' <br />r ,� l. <br />J ?L; —_�i� <br />-��c-1�Ge <br />AODRESS ITY2fP PF'.ONE <br />6F,c�5 Zc� s: Sw�yu��ccD�98o��2s-��Io-19G� <br />HEATSOURCE <br />� Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />��12.,yy�j"-_ <br />(i��, 3=,�►.� pRCKA� I-��i=Y[�hPs <br />�x I S� I NG R�F Cu�S. �oNrJ�C.'T �'p <br />'S'i�l'15 �LECTPJGlL• <br />i� � uunuir_ ue� <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathiub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />BackAow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />Wl-r�+ IJ�1n/, <br />�XlS"71 n1�; <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/G — air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heaf pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritiPj that I have read and examined this application and know the same to he true and cortect. All provisions of laws and <br />ordinaces governing this type ot work will Se compiied with whether specified herein or not. The granting of a permit does not presume <br />to give authoriry to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />consUuction. That I am authorized by ttie owner of this property to peAorm the work for which application is made and I comply with the <br />State Con��c�ors �w 1$27 RCW and 296.200 WAC. , , <br />ts�»E5'i"�t� CO� q <br />