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03;pi�:005 1d:J0 F.4.1" 12588B996J SLiRY RLISE <br />PERMIT APPLICATIOiV <br />CITY OF EVERETT PERINIT SERVlCES <br />3200 CEDAP. STREET, EVERETi', WA 96201 <br />425-257-8810 - FAX 4Z5-257�857 - www.evereriwa.org <br />�002 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SfTE A�DRESS PARCEL LCX IA. M PERMIT # <br />27b(a 10� 5�h"eeY, �'�4�II oo53i3-Ool_ ooi-c� I -,�;��' <br />�G Y� ('+�o��oF lot� I BLiCK I 7RACT /� , , `r <br />oESC.I �N..��. K NCfm4nl t�t�1.61'� 'I'D EVGfG�f � V�J � P%D <br />�.r�-Su.�ka,� �MoX'.yKlis�� �ft`FMer-ri$ A*/eN�� �.tc��h�ve+tc(�qSoyS a�S <br />TENANTHAMF. CONTAC7 FOR PCRMIT PNONE <br />�ux'rer��y umo 'c.u��e.� Mcu'u K145� 425 281- 1370 <br />CONTRACTOR N�ORESS CITY(dP PHONE <br />CONTR IJCENSE / �" �!� 1�)� )�.! �� <br />USE OF BUILDING <br />res � dev�ce <br />1NORK DE9CRIPTION <br />�da�-� wa�s'1� <br />cz�{No K , d f�ei� <br />HEAi sOURCE,' <br />�,ElecVic _Gas_Olher <br />CONTRACT PRICE OF WORK <br />� ,?j� DOD , Oa <br />�]i pes (c.u.rre,�.tt� w.�irl� 3-n�ctu_Ls) , naova hoi- u�af�er i-u� <br />�{o nriV_e foom frar �asha^�d.rbe,^ �s+nclu�) � r�Plc�c� <br />dd d��asher/da�al.� n1ov� ba*t�room �ii�turn.s. P�'1 <br />..�......� ��C/�IJ A \IIP 111 <br />N0. � NPE OF FlXTURC OR ITEM <br />TOilet ` <br />EathWb }MN�- <br />Lavatory (wash basln) / <br />ShowBr <br />Kitchen cink & dispocal <br />Dishwasher <br />Clothes washer Moy�. <br />Laundry tray <br />Sink (servicelbadmop/etG.) <br />Batkflow preventor <br />Urinal <br />Drinking Founta�n <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />N0. I TYPE OF FIXTURE OR ITEM <br />NC - air ha�dling units <br />Forced air systems <br />Gas piplr.g - <br />Watorhea:ar M.oY� Erlbi'V� <br />Gas flrevlac� <br />Gas 2nge <br />Clathesdryer VV,oY� E�uS�'t�V� <br />Range hood �{� <br />Fxhaust tan <br />Heat Dump <br />Unit heater � F� <br />Boiler n � <br />ReMgeration , � � <br />Wootlstnvc I�� j ,�'i �' �/ <br />Other L. L O30 <br />CIYY OF EYEREIT LOCAL $ALES 7{1E GODE IS ? 70: <br />i hcreby ccrNry tAat I have read and examined this appliraGon and know lhe same to be true end mned. ,vi p�ovieions of laws ami <br />ordinaces goveming ihis type of work will be compiied wilb whelher speafied herein or no: The granting of a pertnit doos nct presume <br />to give authodry to violate or cancel the pravision of any other stste or local law regul�tlng corictruction or the peAormarce of <br />canswtion. That I am authorized hy the owner of lhis property to pertorm the work tor which applicaUon is made and I comply with Uie <br />State Contraaors Law 1827 RCW snd 29G200 WAC. <br />