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SITE AODRESS t � <br />E� AL L T NO. <br />DESC. G� I <br />PtRMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />)_C- . <br />BLOCK <br />PARCEL TAX I.D. tt <br />OOO `t 1 0 U <br />TRACT <br />r� �-- �V�t"�— <br />��tJ 7C15-3 � <br />C r; 7�1�-02; <br />N <br />� t� <br />�,rION � ¢ic.,�h �,U��t� �tlu �i;4 Pl.'�F l.��e�T 4Zi 4-1F-3 /i <br />TENANTNAME � CONIACTFORPERMIT PHONE <br />CONTRACTOR <br />izi 1� A�'�S �t uc1 � <br />CONTR. LICENSE M <br />USE OF BUILDINr <br />�� 1 L�. <br />WORK DESCRIPTION <br />NO. <br />�--- <br />� <br />1bLUR'� _T-N'C <br />/�'� D i 1 � u � �T7� <br />s r,� <br />TVPE OF FI%TURE OR ITEM <br />Toilr.l <br />B.+IhWb <br />Lov�ilory (w�sh basin) <br />Shawcr <br />Kilrhr.n slnk 3 Aisposal <br />Dishw.�shor <br />Clalhes washar <br />Watt�r henlr.r <br />Sink (s�ervleo/bndmnp�elr,.) <br />Bar.kllow prevenlcr <br />Urinal <br />Drinkiny Pouniain <br />F loor drain <br />Gronse Irap <br />Roof drains <br />O�her <br />h�rk 1�%��rcn���i�rin jHe 435-55�/�' <br />ADDRESS CITYIZIP PHONE <br />� f� 4 ZS G�Q/1N � CClkY- R D IAQ l.u./��fq.y .jfJ�' <br />�v � . 1 D %�3 <br />HEAT SOURCE <br />� Electrlc _ Gas _ Olher <br />/ <br />o �- � E �U � <br />i <br />4ied' <br />� No I <br />� <br />y3s-ssy�' <br />CONTRACT PRICE OF WORK <br />�3 Z,ODU, 06 <br />C(y4S�7" /9;e�"]4 <br />6�� <br />, <br />TYPE OF FI%TURE OR ITEM <br />A/C - air handlin� units <br />Porced eir syslems <br />Gas piping <br />Walor heator <br />Gas lireplaco <br />Gas rengo <br />Clothes dryer <br />R, nya hoad <br />Cxhaus� lan <br />Hea� pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woods�ova <br />Olher <br />< Z. � t � C i C. �iL7klZ--- <br />CITV OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I herAby corilily Iha� I heve read and eaamined lhis epplicalion anA know Iha same lo be Irue and correr,t. All provislons ol laws and <br />ordinaces govorniny lhls lype of work will be complied wilh whelher specified herein or noL The gran�ing of a permii does nol presume <br />lo givr �uthority to violalo or cancel the provision of any olher state or local law regulating construclion or the performance ol <br />construclion That t em :futhmized by tl;e own�r ot#his propeAy lo padojjjm th work lor which applicetion Is made ond I comply wllh Ihe <br />Slalu Conlr�ctors Lav�,3Y�?7 RCWjancj,2'�8.200 tyYAC. 1/ / 9 <br />� � 4� � � � �C, C/ / <br />ll <br />�I <br />� <br />