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SITE ADDRESS <br />Z�'�% <br />LEGAL� LOT NO. <br />DESC. <br />PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE i, EVERETT, WA �8201 <br />425-257-8810 — FAX 425-257-885"1— wwrv�.everett�va.org <br />APPLICATIONS ARE ACCEPTED FROPJI 8 AM TO 4 PM <br />,.! FARCEL TAX I.D. # <br />/� /s;�Z-D�r,'- �� U v ' Li a �J <br />BLOCK TRACT OR SUBDIVISION X <br />� �....�.. <br />�/f�/'�T yo�✓ir��� �dT/ln,�'o Ty' <br />TENANT NAME <br />�r,,,���- <br />CONTRACTOR <br />�vr,��T f�:�vri��� h'v.'/�/'r <br />CONTR. LICENSE � <br />USE OF BUILDING <br />��� <br />S/[%�? Cr-��'j�i���P' <br />COIJTACT FOR PERMIT <br />n,,✓ �✓cF�� <br />HEAT Sqt�RCE <br />/ <br />_ Eleclric V Gas _ <br />Other <br />WORK DESCRIPTION <br />/'���i/'�/'-�'liarr'�l c�,�i �iir��� •��sip�-�cE <br />NO. <br />� <br />Tl'PE OF FIXTURE OR ITEM <br />Toilet <br />BatMub <br />Lavatory (vdash basin) <br />Sho�ver <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Flour drain <br />Grease trap <br />Roo( drains <br />Other <br />NO. <br />PERMIT # <br />j /�.��c,�. ii� 0 <br />PHONE <br />/�'.T rn�'. L .% �b <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEh1 <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />s range <br />lothes dryer <br />Range hood <br />Exhaust fan <br />!'eat numN <br />Boiler <br />CITY OF EVEr�ETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and kr,ow lhe same tc be true and correct. All provisions of laws and <br />ordinances governing this type of work wilt be complied with whether specified herein or noL The granting of a permit does not presume <br />to give authority to violate or cancel ihe provision o( any olher state or local law regulating construction or the peAormance of <br />construclion. Thal I am authorized by the owner o(this property lo periorm the worh for vdhich appliwtion is made and I romply with the <br />State C�ryiray(ors Lav� 1827 RCW and ?.96200 VJAC. <br />