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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERViCES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS �T�,, PARCEL TAX I.D. # <br />�j/l3 � 4� �E Go�,�yoz00000s� <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # <br />�Eso. S oco-6- /��✓ir, �i�•v�,�,v� Di✓. �io � <br />�D�U^�� /�F-�N�'N��� 9u3 �;ti /�, � �r/��,vT <br />TENANTNAME <br />QGt//!F/�- <br />__......._._.- �+//� <br />��r <br />CONTR. LICENSE # _ <br />fJCA <br />USE OF BUILDING <br />�'1��- <br />CONTACT FOR PERMIT <br />Y.firC,�p%� F;i�ly. <br />����/� ADDRESS/a�,i6���II�S <br />t U n} <br />�%�5 <br />�li, �,j � <br />HEATSOURCE <br />_, Electric !�Cas _ Other <br />6-a-�� <br />PERMIT # <br />PHONE !i�' <br />7 <br />�xar�n� <br />l�- <br />yzs - <br />si� - zx: <br />-9GC'n <br />'NF�t.✓Z <br />���!!2, C�lf ���G�n � <br />��o// <br />CONTRACT PRICE OF WORK <br />29�5. °° <br />WORK DESCRIPTION <br />�F%�l-�'� �,✓4• i�.,� �s�l��.: c'..�; w.� i� HF�': cJL w:��+' �'�/�� G, �sS rF'n�Kt��S <br />c�/��.L h'F-�c E/'— <br />I�Na <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (snrvicelbar/mople�c.) <br />Backflov+ preventer <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />MECHANICAL. <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC — atr handiing units <br />Forced air systems <br />�Gas piping <br />Water heater <br />�� Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refriaeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES SA7( CODE IS 3105 <br />I hereby certify ihat I have read and ezamined Ihis application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will 6e complied with whether ,pecified herein or not. The granting of a permi� does not presume <br />to give au�horiry to violate or cancel the provision of any other state or loral law regulating construction or the performance of <br />construcl�o hat I ain aulhorized by the ovvner of this propert�; to periorm the work for which application is made and I comply with the <br />Slate Co r� tqr,� av� 1627 RCW and 296200 WAC. <br />/��%✓I Ih �� �S��a <br />