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SITE ADDRESS <br />/2� vz i �7'�'A✓; <br />LEGAL LOT N0. <br />OC-SC / � <br />PL�ZMI�' APPLICATIG. � <br />CITY OF EVERETT PERMIT SEf�VICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.O. # <br />-�� O(vb y'7oaoc�5�� <br />BLOCK TRACT OR SUBDIVISION 7i <br />� <br />_b-�D <br />PERMIT # <br />/' _ /�C l G�/� � <br />�y �0 6'i'X �7cc7 G�y�JN�Jno..�/yp,•/v L>Zi -7vs-�f3311 <br />L /% '? �i /-�'�ac �'r,�iad�,�I <br />TENANT NAME � CONTACT FOR PERMIT PHONE �ZOG GL f/ Jo � <br />�a�-S�f �✓I..�,4T,iJSE•J E-MAIL /Jr'-r�-rhkre�t ���1��� d�+- <br />Ml/UttCJJ <br />j9-� J�l� � LG� ' CG �i=,r 2�iZ� <br />COtJTR. LIC[NSE k <br />/�✓I.�,G �!� NL ��s� v,� <br />USE OF BUILDItJG <br />�rNG�. nc�ri� � R�rS rJ1=�JCr <br />— -- ��� �isz� <br />�� <br />HEATSOURCE <br />_ Eleclric �Gas _ Olher <br />WORK DESCRI?TION <br />NO. <br />�_ <br />� <br />P <br />TYPE Of- FIXTURE OR ITEM <br />l odcl <br />6ath�ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & duposal <br />Dishwasher <br />Clolhes washer <br />Wa�er healer <br />Sink (serviceNadmople�c.) <br />Backllow preven�er <br />Urinal <br />Drinkiny Pountain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />N0. <br />�./�lb�y(�.,�.��oG io65-/9a <br />CONTRACT PRICE OF WORK <br />M <br />TYPE OF FIXTURE OR ITEM <br />AIC — air handling unAs <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas (ireplace <br />Gas range <br />Cbthes diyer <br />Range hood <br />[xhaust fan <br />Heal pump <br />Unil heater <br />13oiler <br />Relrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />t hereby cerlify Ihat I have read and exainined ihis applicalion and know ihe same lo be Irue and correct. All provisions o( laws and <br />ordinances governing this lype o( vrork �vill be complied with whether speci5ed herein or nol The granting o( a permil does not presume <br />to give au�hority to violale or cancel the provision of any other slate or local law regulating conslruction or the performance of <br />constr tion. hal I a authorized by the owner of �his property to perform the work for which 2pplication is made and I comply wilh Ihe <br />Slate onlr. t� L� < < 62 WAC. <br />' 2 Z3 l� <br />i naWi of OwnedCenliactod�u�honced P.yenl D�t � j <br />� ��Z <br />