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. <br />SITE ADDRESS <br />rn�/ �;" <br />LEGA LOT N0. <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY 4F EVERETT PERMIT 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 <br />`E , <br />BLOCK <br />Ic.v�c/ <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION M <br />ADDRESS <br />5�,�'i Zc'rS..�,�:� `—C_ <br />CONTACT FOR PERMIT <br />.�ta�'_.N „� �z <br />R�LV�FI.A�'nF_ LLC. �111(y220'�`� <br />CONTR. LICENSE A <br />USE OF BUILDING <br />('� ��e,,,,�'{� <br />WORK DESCRIPTION <br />%._. �"9�-(i0 <br />PERM # <br />'M D'7 -�(o <br />�Iti �'r> <br />c: c1'�c'�� �CJ�C�u <br />c.�tS'=<<i'�C-`:�. <br />a ( mo�.,r1D.K¢k���� `IBO`i� k25-?"7i-1i3`l <br />���—C� <br />HEAT S< <br />Electric .� Gas _ Other <br />. .(ip,<r. <�.r.� /<,..n.,.. _ r,�/�� hc, ti�.z ..�. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toile� <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />W ater healer <br />Sink (service/bar/mop/etc.) <br />Oackllow preventcr <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grcasetrap <br />Rool drains <br />Othcr <br />CONTRACT PRICE OF WORK <br />i'?Cr�: � <br />N0. I TVPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />1, Forced air sys�ems <br />Gas piping <br />Water heater <br />Gas lirep�ace <br />Gas range <br />Clothes dryer <br />Range hood <br />E>:haust tan <br />� Heat pump <br />Unil healer <br />Boiler <br />Refrigera�ion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby ccritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming this rype of work will bo complied wi�h whether specified herein or not. The granling of a permit does not presume <br />to give authorily to violate or cancel the provision ot any other stato or local law regulating construction or the performance of <br />construction. Thal I am au�horized by the owner of this proprrty to pedorm the work for which application is made and I comply with Ihe <br />c��i� r.nntracmrs Law 1827 RCW and 296200 WAC. <br />�-- <br />I-�3 -Og <br />