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P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERyICES <br />3200 CEDAR STREET, EVERETT, WA 982U1 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />SITE ADDRESS <br />G �L 5'�' <br />LEGAL L!T NO. <br />DESC. (�(n��r '�� <br />OWNER <br />QCSE NO/H,FS �N(, <br />TENANTNAME <br />CONTRACTOR L�S U � <br />CONTR. LICENSE A <br />vs� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PhA %� � 9— 07 <br />PARCEL 1..w I.D. M <br />�,�ie r S� � Z�o6 � Bc+o3n 8'/cb <br />BLOCK TRACT <br />AUDRESS C <br />��7uG lV!/�titiC �K.� �/J/��►"rpi <br />CON ACT F R PERMIT <br />�i ✓ IC�e/� p�D �/!y c <br />� y�� � ADDRESS S/'%M� <br />�z "� dvzJL <br />USE OF BUILDING <br />s. r � <br />WORK DESCRIPTION <br />L: J.✓r i .ec[fTi'c'� d� <br />HEATSOURCE <br />Eloctric �Gas Othnr <br />PERMIT p <br />�?� ,�, � I <br />',Y/c 36o-Gsz-7ss/ <br />' PHONE <br />6l�tts 3�d-�sz-7.S�j <br />CITY2IP PHONE <br />CONTRACT PRICE �JF WORK <br />�s'�'^S�Ic.� �iiyn•7r �C—s� /� L`NC[5 (�.J�2Y � ZZLJ <br />NJ. I TYPE OF FI%TURE OR ITEM <br />`� Toilat <br />� Bathlub <br />� L�rvatory (wash basin) <br />� Shower <br />_L Kitr,hen sinF 8 dis{x�snl <br />� Distnv�sh�r <br />/ Clolhes washcr <br />% Wa�er hr.alor <br />�— Sink (sorvicF�/6admoplela) <br />— �ackflow provr.Nr.r <br />Urinal <br />— Drinking Founlain <br />— Floor dnin <br />— Graase trap <br />�1 Ronl droins <br />` Olher <br />MFCHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />'—' PJC — air handling unils <br />J Forced air systems <br />�� Gas piping <br />�_ Walor hoaler <br />� Gas fireplaca <br />� Gas rango <br />� Clolhos dryer <br />�Range hood <br />Exhauslfan <br />.-- Heat pump <br />-- Unithoalor <br />----. BOI�Cf <br />.— Rolrigeration <br />-- Woodstove <br />Olhor <br />CITY OF EVERETT LOCAL SALCS TA% CODE IS 3705 <br />I hereby corilify �hat I have read and examined Ihis applicati m and know tho same to be true and wrrect. Ail provisions ot laws and <br />mdinaces goveminc� Ihis type of work will bo compliod wi�h whe�har specifiod horoin or noL The granting ol a pormil does not presume <br />to givo authority to violato or cancel Ihe provislon of any olher stale or local law rec�ulaling conslrudion or the performance of <br />construclion. That I am aulhorized by Iha owner o( Ihis properly to perlorm tho work lor which application is made and I compty wlth Ihe <br />Slala Contreclors Law 1o.27 RCW and 2�J6.200 WAC. <br />