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SITE ADDRESS d- <br />vo � s <br />LEGAL � NO. <br />DESC. uN�T � 7 <br />i <br />F��RMIT APPLICATIUN <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. A <br />� ' • <br />I - � _ � <br />PERM�T # <br />'_��o-�i <br />360- bs z �s�� <br />TENANTNAME ' I CONTACTFORPERMIY � � PHONE <br />�N R[-eN A/e �.�aY S�r/�ts �bo-Gsz- 759i <br />CONTRACTOR AUDRESS CITYIZIP PHONE <br />�Oa& 'fi+�M�s, IN�• 117oG MARiN6 �Liur3 ii�ARr3✓!/�6�18�7/ �e-f.SZ-7S1/ <br />CONTR. LICENSE p <br />USE OF BUILDING <br />s�. F. R. <br />WORK DESCRIPTION <br />HEATSOURCE <br />Eloclric ✓ Gas Olhor <br />CONTRACT PRICE OF WORN <br />I.oa�nerscr;e�✓ of .s'.'�ry/6 iia,•.��'ty R6a:aE,v� fP/A.v 9) BAs.� w2ie <br />NO. � TYPE OF FI%TURE OR ITEM <br />_L <br />_L <br />0 <br />A <br />� <br />e <br />d <br />Toilot <br />BathWb <br />Lavoto� (wash basin) <br />Showcr <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washor <br />Watur healor <br />Sink (sor•'ce/hadrnoplclr..) <br />�ackllow prevenlcr <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Ruol draL u�. <br />Olhor <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - nir handling units <br />Forced air sysloms <br />Gas plping <br />Watcr hoator <br />Gas tiroplaco <br />Gas ranga <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unil hoalor <br />Boilor <br />Rofrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE �S ]105 <br />I hereby cerilify Ihat I have read and examined ihis application and know Iho same lo ho lruo and correct. All provisions of laws and <br />ordinaces c�ovomin� this typo o( work will bo compliod with whether spacilied herein or not. ?ho granting of a permit does not presume <br />to c7ivc authorily lo violato or cancel Ihe provision ol any olher stalo or local law �egulating construction or Ihe perlormance of <br />conslruction. That I am authorized by Iho ownor ol lhis property lo porlorm lhe work lor which applicalion is made and I comply with Iho <br />Stato Contractors Law 18.27 RCW and 29fi.200 WAC. <br />/0 �f/•I �i <br />