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--t <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 — FAX 425-257-8857 — www.everettwa.org <br />APPI.ICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM - DE81T 3 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRt83 <br />LOT NO. <br />DESC <br />BLOCN I TRACT <br />PMCEL TAX I.D. N <br />N <br />5r1-ev en K� ke.� 9 � I � o�M�t. P � s� 6vuuF 9x�b � zs • 48l • �oo� <br />TENANT �AME � CONTACT FOR PERMIT PHONE <br />' fio 1 I Y� Y/� �/ �(il L <br />CONiRAC10R aC� �� �1k �,( (,� ADDRE88 SZ IL �b�}h CITV2IP PHONE <br />� S� . S�,J , d $ LyHnwooe0 'IZS- �q3 -Z3 i <br />CONiR. LICENSE M 9�037 <br />(�4G=FV1.96162 c�/. l�ob <br />USE OF BUILDINO I — HEAT SOURCE I CONTRACT PRICE OF WORN <br />R�IU__ 1 1� Elect�ic X Ges __ Olher �p�ps 0��. <br />r.VTt' � <br />WORK DE9CRIPTION <br />%r�Q�ac�:.�oJ ex :�}; r� �ooF krus3G,5 <br />�(e,�lw« C1na.ircd 0.+v�'�n9 MtmbwS AS Y1ttcF� <br />TVPE Of FI7ITUNE OR ITEM <br />Tailet <br />Balhtub <br />Lavatory (wesh besin) <br />Shower <br />Kllchen sink 8 disposal <br />Dishweshe� <br />Clothes washer <br />LuunAry �ray <br />Smk (servicelber/mop/etr, ) <br />Beckllow pieventer <br />Urinnl <br />DnnWng FOUntAin <br />Floor drein <br />Greasa Irap <br />Rool dreins <br />Olher. __ .. . . _ <br />I—. _ __ __.__— __._� <br />TVPE OF FI7fTURE aR ITEM <br />AIC - alr hendling unils <br />Forced eir syslems <br />Gas piping <br />Welar haeler <br />Gas lireplece <br />Gas renge <br />Clolhes dryer <br />Rengahood <br />Exheus� len <br />Heat pump <br />Unil healer <br />0oiler <br />Relrigeretion <br />Woodstove <br />Olher <br />CITY OF EVERET7 LOCAL 8ALE8 TAIf CODE 19 7105 <br />I herr.by ceritity thet I have read end examined Ihis epplicalion and know iha same lo be Irua end correct. All provislone ol lewa end <br />� ardmeces governing Ihis type ol wo�k will be complied wilh whether spacilied herem or noL The granting ol e permit does not presuma <br />Ilo grve eulhonty to violete or cancel the piovision of eny other stete or local lew reguleting conslruction m the performence ol <br />� conslrucuon Thet I em aulhorized by the ownar ol lhis propeAy Io perform the work lo� which epplicetion is mede end I comply with Ihe <br />Slale Contractors Lew 1827 RCW and 296 200 WAC. <br />