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PtRMIT 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 ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />i z �l k 20� /�-r� <br />LEGAL LOTNpO. BLOC <br />DESC. #0 (J(a('j..� <br />OWNER <br />� �-,e,e ,� S.OLlS.e ��' <br />PARCEL TAX I.D. # <br />G� G � b 2zC�t.�CGc�'G� <br />TRACT OR SUBDIVISION # <br />}��SCllt-IP ra-t�Dl i IoN <br />/J�/� ��1�, �J6� .f`� <br />I �--a0 --4 <br />r� �1 <br />� <br />TENANT NAME CONTACT FOR PERMIT PHONE � f Z S-��j" ?j �J 6 <br />nf---(� ��,�� /� <br />��f2' /�lt%JJ/JriN E-MAILP�-' ��Ilv-.vTIQa.�'lGwaY� <br />�TR��ACTO�R �_� , �tG jvNK /N ADDR � <br />i-�r�-(�(�-�'{n P-�anUDf-1 � L.��3�fr- 1 NC. �Zi 1-2 Co%�l /av£ �:�u.10 ti�MlSt1 W F1 �"�Z9C <br />CONTR.LICENSE#,1L,��-r•br �-3��\� GfZ]"_7)�j—j'7�.� <br />TT cr� r--� FL v � <br />USE OF BUILDING <br />HEATSOURCE <br />_ Eleclric _ Gas _ Olher <br />WORKDESCRIPTION ��S�i ���rnGN� L�NDF�� �V-� GNG�/ <br />NO. <br />BING <br />TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/mop/elc.) <br />Backllow preventer <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher __ <br />CONTRACT PRICE OF WORK <br />-�/3,� � <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/G - air handling unils <br />Forced air systems <br />Gas oiping <br />Watd; heafer <br />Gas tireplace <br />Gas range <br />Cblhes dryer <br />Range hood <br />F.xhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritiiy that I have read and examined lhis applicalion and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming lhis type of work will be complied wilh whether specified herein or not. The granting of a permit does not presume <br />lo give aulhority to violate or cancel the provisio.i of any olher stale or local law regulating construction or lhe pedormance of <br />conslruc n. That 1 am authorized by the owner o( this property lo per(orm the work (or which applicalion is made and I compty with the <br />Stale C nt ctors Law 18.2��2CW and 296.200 WAC. <br />��Z <br />,� <br />