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SITE ADDRESS <br />Ji--� �r� <br />lEGP1 O. <br />DESC. u ' 12 <br />��� <br />TENANTNAME <br />CONTRACTOR <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, �NA 98201 <br />425-2.57-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />•.- s, E. <br />BLOCK <br />CONTR. LICENSE M /� � <br />I`�Sl }F•� 'F <br />USE OF BUILDING <br />S <br />WORK DESCRIPTION <br />� i9� <br />PARCEL TAX I.D. p P�RMIT A <br />,�os�800.�3yoo C �o� - a�3 <br />TRACT <br />ADDRESS CITY2IP 9�13HONE <br />^A 7 <br />��n6 I,IAi2iNG�,�.. N�r�a��sf,�lE 36o-(v5z-7S9/ <br />CONTACT F R PERMIT PHONE <br />3bo-Lsz- 7Sy <br />ADDRESS $AIrl� � CITYIZIP PHONE 96n-bi2.- 754� <br />NEAT SOURCE I CONTRACT PRICE OF WORK <br />Elactric ✓Gas _ Othcr <br />L"vN-Tr�Ccl�Tio�✓ oc •si�vy/�% filM,'[y �c�,'vE�v�et (B.as:� a��2z� <br />N0. I TYPE OF FIXTURE OR ITEM <br />3 Toilot <br />'�' Balhtub <br />� _ Lavatory (wash basin) <br />� Shower <br />�_ Kilch�en sink 8 disposal <br />� Dishwasher <br />(_ Clolhr,s washcr <br />�_ Wator hi�alor <br />— Slnk (soivicelbar/rnnplatc.) <br />-- Backflow preventer <br />— Urinal <br />— Drinkinc� FwNain <br />Floor drain <br />— Greaso Irap <br />� Roof drains <br />.— Olher <br />NO• I TYPE OF FI%TURE OR ITEM <br />� <br />wc - au nanoung unns <br />� Forced air sysloms <br />� Gas piping <br />� Water hoalor <br />�� Gas liroplaco <br />� Gas rango <br />i�_ Clothos dryor <br />�.F Ranye hood <br />Exhausllan <br />— Hoal pump <br />— Unit hoater <br />+ Boiter <br />— Rolrigeration <br />Woodslove <br />— Olhor <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br />I ht�reby coritity �hal I have read and aKamined Ihis applica�ion and know iho same lo be lruo and correct. All provlslons of laws and <br />ordi�aces yoverning ihis �ype ol work will bo compliod wi�h wholhor speciliod herein or not. The granting ol a permit does nol prosume <br />lo givo auth�nry tu violslo or cancnl the provision of any other slate or local law rogulating conslruction or lhe perlormance of <br />cons�ruc�ion. Tha� I am authorized by �he owner ol Ihis property lo perform Uie work lor which applicalion is made and I comply wilh lhe <br />Slalo Contraclors L�w 18.27 RCW and 296.2W WAC. <br />