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PEkMIT APPLICAiION <br />CITY OF EVERETT PERMIT SERVICE'+ <br />3200 CEDAR STREET, EVEr�ETT, WF, 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org /�N/n " 9" <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTFD <br />SITE ADDRESS <br />5�29 <br />LEGAL LOT N0. <br />DESC.� � � <br />��✓E CJ • � <br />BLOCK TRACT <br />� Op/-O� cJe <br />PARCEL TAX I.D. # <br />o�0o�oo8n� <br />� �i� .Z. �i✓ ,�. �L . <br /># <br />-- 2 <br />c�.6 �',a�c ( o..F; �� ��3<su 3�� /�r�a� 9��'i9 �Zoy) �i9-��1i3 <br />TENANTNAME CONTACTFORPERMIT PHONE <br />�CONTRACTOR / AD�RES� CITYl(Z.IP PHONE <br />/,�(.c.L`-' 2„J6G.�'c�..s,—_ lti.c %ia�sK 3�, %,cJt�'.�c.c�� F'�O�`J �Z.o6��'/`i'-'7ti//� <br />CONTR. LICENSE X � ` � � • •'� • . .. . , , . ' <br />�����eL.9�.6. J�, . '.,;. <br />USE OF BUILDING <br />WORK DESCRIPTION <br />� � HEAT <br />Nc-z�1 0.1aen� �-k'-r-ttir- � <br />NO. I TYPE OF FIXTURE OR ITEM <br />5 Toilet <br />2 Bathtub <br />� Lavatory (wasl� basin) <br />/ Shower <br />� Kitchen sink & �]isposal <br />� Dishwasher <br />� Clolhes washer <br />_L Laundry tray <br />Sink (servica/bar/mop/etc.) <br />_ Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />Electric u Gas _ Other <br />��� <br />NO. I <br />CONTF2ACT PRICE OF WORK <br />�/�S�'��n� <br />/�;�r C"� f 63 <br />TYPE OF FIXTUR[ OR iTEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />W ater heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />Rangeliood <br />Exhaustfan <br />Heat pump <br />Und heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL 3ALES SAX CODE IS 3105 <br />I hereby ceritify that I have read and examined tnis application and know ihe same lo be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with �.vhether specified herein or no:. The granting of a permit does not presume <br />lo give authority to vio ate or cancel the provisicn of any other state or local law regulating consWclion or the performance of <br />construction. That I m thorized by tne owner of this property to perform the work for wnich application is matle and I compty �vith the <br />Slate Contractors Law 1.27 RCN! ana 296.20a/✓AC. <br />0 <br />