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S;U <br />SITE ADDRESS <br />��, 9,� - <br />LEGAL �NO. <br />DESC.� u�'l M /3 <br />�� � <br />TENANTNAME <br />CONTRACTOR � c�SE <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SrRVICES <br />3200 CEDAR STREET, EVERETT, VJA 98201 <br />425-257-C810 — FAX 425-257-8857 — www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� PARCEL TAX I.D. M <br />�r J'. E j ,2806/�00303'.'� <br />BLOCN tRACT <br />CONTR. LICENSE N <br />Rf�k. �� • � � i <br />USE OF BUILDING I <br />S.F� <br />WORK DESCRIPTION <br />��•i✓s ' ,C�[ c r i oi✓ <br />PLUMBING <br />NO. I TYPE OF FI%TURE OR ItEM <br />..3 Toilo� <br />f� Ba1hWb <br />� Lavatory (wash basin) <br />/ Shower <br />_I Kilchen sink 8 disnosal <br />/ Dishwasher <br />� Clolhes w2shur <br />_j` Walor heater <br />� Sink (sorvicc/6ar/mop!elc.) <br />— Oackfiowprevenlr.r <br />Urinal <br />Drinkin{� FouNaln <br />.� Floor drain <br />Groaso Irap <br />� Roof drains <br />— Olhcr <br />/�7a6 N/atil��c<< <br />CONTACT FOR PERMIT <br />AIEN �co�/ a/n k <br />r • ADDRESS S'AN/G <br />��{'Z�v�i <br />HEATSOURCE <br />_ [lectric �iGras _ Othor <br />u� ����/c� ��i+���y <br />7 —��' - O �� <br />PERMIT k <br />C <br />C.. ?/I /. <br />l�l% 3t o -tsz-7-sr, <br />PHONE <br />3G,o- Gsz- 7ssj <br />CITY2IP PHONE <br />CONTRACT PRICE OF WORK <br />,�,s,;,�G,�,rc= %�s,� z,b) <br />NO. I TYPE OF FIXTURE OR ITEM <br />'— NC - air handlii � units <br />� Forced air systems <br />�� Gas piping <br />J_ Watorhoater <br />Gas lireplaco <br />� Gas rango <br />� Clothos dryer <br />� Rangohood <br />Exhaustfan <br />' — Hoal pump <br />— Unit hoator <br />� Boiler <br />Ralrigeralion <br />— Woodslove <br />— Olhor <br />CITY OF EVERETT LOCAL SALES TAX CODE 19 7705 <br />I horeby coritify Ihat I liave road and oxamined Ihis application and know Iha same lo be true and correcl. All provisions ol laws and <br />ordineces povmninc� Ihis lypo of work will bn compliod wilh tvhelher specifiad horein or not. The granling of e permil does not presume <br />�o give authorily lo vinlate or cancel Oie provision ol any olher state or local law rogulaling contlrudion or iho perlormance of <br />construction. That I �m authorized �y tho owner ol this proporty to poAorm Iho work lor which appHr,alion is mede and I comply with lhe <br />Slalo Conlractors Law 10.27 RCW and 29fi.200 WAC. <br />� i/9�0 <br />