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P�RMIT APPLICATIUiV <br />CITY OF EVERF_TT PERMIT SERVICI=S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wv.�w.everettwa.org � �'�y '.� <br />APPLICAI iONS ARE RCCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT AC�EPTED <br />SITE ADORESS <br />� hQ PI • S� <br />LEGA LOT NO. <br />DESC. <br />Y <br />OWNER <br />TRACT <br />PARCEL TAX I.D. M <br />�Sc�9 3� <br />� �� ���•�HONE . M. <br />�td�.cf %►a� f-io.u�s o� Ev�r��F.�, LLC �Z5- 9/p'H' YI. SE. E.v�t��i7e�O.IL3A <br />TENANTNAME CONTACTFORPERM T PHONE <br />��YIGI.t. FJs.KtIIN Cu.��- Jol�nsuK �iI�S•�30•IL30 _ <br />CONTR�OR —�1 � t��� ADDRESS �yZOt� PNONE�� <br />C00.:TR-� COY1STru-L.�10Yt <br />CONTR. LICENSE C sy � �„ p` 3.e � J� �'� 57v 163 U <br />r,�RST�Ra��___ � <br />USE OF BUII DING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />_ Eleclric �Gas _ Other <br />WJRK DESCRIPTION <br />►ro,aou.- <br />ca�s�-,u.�+ v�tw sr�y�.�-�►���y ►-tsrdtK�. �i'o« %4C) <br />PLUMBING <br />NO. � TYPE OF FI%TURE OR ITEM <br />Toilel <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 d:^,, ose: <br />Dishwashor <br />Clothes washer <br />Laundry tray <br />Sink (service/barhnopletr..) <br />BackOow prevoNcr <br />Urinal <br />Dr�nking Fountain <br />Floor drain <br />Crease trap <br />Roof d�ains <br />Other <br />NO. � TYP'E OF FIX7URE OR ITEM <br />-;�— <br />A/C - air handlini� units <br />Forced air syslons <br />Gas pipin9 <br />Weter heator <br />Gas (ireplace <br />Gas renye <br />Clolhes dryer <br />Ranqehood <br />Exhausl lan <br />Neal pump <br />Unit heatnr <br />Boiler <br />Re(rigeration i <br />Woods�ore ✓ <br />CIN OF EVERETT IOCAL SALES TA% CO�E IS J70S <br />I hereby cenlify that I have read und ezamined this applicalion anA know tho same lo be true and correcL All provislons ol iaws and <br />ordir.aces yoveminy lhis type ol work will be complind wilh wholher spedlied herein or not. The granting of n permll doas not prosume <br />lo yive authonty to violato or cancel �ho provision ol any other slate or local law regulating constructlon or the performance ol <br />construclion. Thal I am authorized by lhe owner o( ihis property lo periorm Ihe work for which applicalion is maua and I comply wllh lhe <br />Stete Contractors Law 18.27 RCW ard 29G.200 WA��. <br />