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PtRMIT APPLICATI(.►�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />SITE ADDRESS <br />27 03� <br />LEGAL LOT NO. <br />OESC.� � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCELTAXI.D.# <br />Sk (,�5�711s <br />BLOCK TRACT OR SU6DIVISION N <br />I++vv <br />D <br />PERMIT It / <br />� 1�. � ' � � � 1 <br />�. � -- <br />�-876 -Si9b <br />T�Ei��a I�r�� �l929 N s� Ac� G1• �'j1uKi�T�p 9k'z75 <br />TENANT NAME CONTACT fOR PERMIT PHONE N� _�8 - 7/'/0 <br />/,N'�,�K [.I�CNiy e•Ma�/7AeK�i�x�TiMaE�Ee��R , <br />�— - �iTVZI� �Ff <br />/x�T oNcE ,�Pa�,Q.S L�f �izz 1oo�`-S�:s'al �y,✓nkubD 9dos(� Hss-�%S-G�z� <br />CONTR. LICENSE fl � <br />r � x ►T0�93�?'i'C <br />USE OF BUILDING <br />sin�GL� n�M�cy Rrsix�vcE I <br />WORK DESCRIPTION <br />�E.i�9iQ O/- ji�f� AAsrACE <br />NO. <br />/ <br />� <br />/ <br />PLUMBING <br />TYPF OF FI%TURE OR ITEM <br />Tuilr.l <br />flalhtuli <br />Lavalory (w:isl� luism) <br />Showor <br />Kilchr.n sink 8 dispos�l <br />Dishwashcr <br />Clnihes washar <br />W��Icr heater <br />Snk (servicc�bar/mop�otr. 1 <br />�ar.k0uw prev��+nler <br />Urina� <br />Drinking faunlain <br />Fluor drain <br />Groase Irap <br />Rool drains <br />Olhor---. .._._ _ <br />— --- _— <br />HEAT SOURCE I CAONTRACT PRICE OF WORK <br />kFlor,lrir,—Gas . Olhor /�'�_� _ <br />NO. <br />MECHANICAI <br />?YPE OF FI%TURE OR ITEM <br />A/C - �ir handling unils <br />Forc�d au sys�ems <br />Gas piping <br />Wfl�r,r healcr <br />Ges lireplaco <br />Gas ran�c <br />Clothes dryor <br />Rangr� hooA <br />Exhausllan <br />H��d pump <br />Unit h�taler <br />Boiler <br />Refriyoretion <br />Woodstove <br />i Other----_--_----- <br />CITY OF EVERETi LOCAL SALES TA% CODE IS 7105 <br />1 hr.reby ceri�i(y Ihal I have read and examineA Ihis applicalion anA know Ihe sama lo be lrua and correcl. All provisions ol laws end <br />ordinaces <�oveming Ihis typu ol work will be r.. mplied wilh whether specih�ad herein or nol The c�ranUn� ol a permil dues nol presume <br />�o give authority lo �iolate� or can��.ol Ihe pruvieion of any other stala or lucal law regutaling conslruction or Ihe pedormance of <br />conslrucliun. That I am aulhonrc+d by lhe owner ol ihis property lo perlurm tho work br which application is made and I wmply wdh the <br />State CunlracWrs Ln•v IH 7�RCW and'141i 700 WAC. <br />�P�/,�� " - -- ---� 2� _^l-- <br />tiiynelure nl O nen ,onlnc _ uthonrod Agenl Oalo <br />