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SITE ADDRESS <br />g�t/� 7 <br />PtRMIT APPLICATIt7N <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 FRUM 8 AM TO 4 PM <br />�^/� �LoQ PARCEL TAX I.D. # PERMIT # <br />��E .r�. �"'�7" Z�tl,t/�Oo.�08�foo I�OFv3-o3�,' <br />LOT NO. BLOCK TRACT OR SUBDIVISION # <br />SE� .4�rt- D <br />Mtif <br />,9�i�'fFv..iy 'a . �rt�t`Cau�ZE �7/Z J��'��G. !�!. �/v��Gc.s�d r�✓� 4 ii�i� <br />TENANTNAME CONTACTFORPERMIT PHONE <br />.eo% �✓ i nNy itl� cv� �6 "�' � " �y� �,w�ss�.,c <br />/%i��/ � �i E-MA�L : o Y � Lv <br />cuninn�i�n �'O/Z✓�` GO��. <br />CONTR. LICENSE # �ozyE�- /3 b+ L,s <br />USE OF BUILDING � $� <br />i_ = � <br />WORK DESCRIPTION <br />/ZOoF,Qf.//f'i.� �OYJl�-�� <br />N0. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />hwrtcaa �.n uur rnvnc Z06 � 9J <br />,S�ArTz� '^��'�f6/4tf 8z7� <br />3Z// �i4�tri.v Lv �� Kii✓6 sR, wA+I so rr� <br />HEAT SOURCE <br />�Electric �Gas _ Other <br />NO. <br />CONTRACT PRICE OF WORK <br />.� 'i�y� � o f�"• ? v <br />TYPE OF FIXTURE OR ITEM <br />NC— air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas 4replace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woadslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODF IS 9105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type ot work will be complied wilh whether sper,ified herein or nol. The granling of a permil does not presume <br />lo give authorily to violale or cancel lhe provision of any other slale or Iocai law re�ulating conslruction or the performance of <br />conslruction. Thal I am thorized by the owner of lhis property to pedorm the work for which application is made and i comply wilh the <br />Stale Conlraclors ,7/R�C�W and 296.200 WAC. <br />. . ���i/���� 3�v3��0� <br />��Z <br />r+l <br />