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SItE ADDRESS <br />1� <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />�� ��t <br />tENANTNAME <br />- -i - <br />PERMIT <br />APPLICATION <br />CITY OF EVERETT PERPAIT SERVICES <br />3200 CEDAR STRFET, [`'ERI=TT, WA 98201 <br />1� 425-257-8810 – FAX 425-257-8857 - www.everc!itwa.org <br />1 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />AARCEL TAX I.D. p P� M(� �_� /;� <br />;�, O� s..� ov y�o� oo i�1�vc� ��� c. <br /><� � c. <br />CONTRACTOR � � �^� <br />CONTR. LICENSE <br />USE OF BUILDING <br />WORK DESCRIPTION <br />��Lf/C '� 5 � <br />BIOCK I TRACT <br />�� L- <br />— PLUMBING <br />NO. I TVPE OF FII(TURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwathor <br />`.�OIhdS W�S�IAf <br />Watcr heater <br />Sink (sorvico/barlmop/olc.) <br />Back�ow preven�er <br />Udnal <br />Drinking Fountain <br />Floor drain <br />Grnase trep <br />Roof dralns <br />Olher _ <br />3G'' <br />�v •- '� _ <br />CONTA FORPERMIT PM�NE <br />� .�b �'� �.✓ �s" ���� <br />Al��S/ , I�iC4C� AYY ��sN'/I� PH(9X <br />�'� �?%0 .?�D �jr�'v <br />HEATSOURCE <br />_ Ele!cl�ic �Gas _. Other <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FI%TURE OR ITEM <br />AIC - alr handling units <br />forced air systems <br />Gr. �Ipiny <br />Water heater <br />�as fireplace <br />C �s rarge <br />Clo�hes Aryor <br />Range hood <br />Exhaustlan <br />Heal pump <br />Unil hoater <br />Boller <br />kefri{�eratlon <br />Woodstove <br />CITY OF El�ERER :.00AL SALES TA% CODE IS J105 <br />1 hereby corilify Ihat I hav� read and examined Ihis applicalion arJ know lhe same lo be irue and covact. All provlsions of laws and <br />orAinac�s gowrning Ihis type ol work will be complied �vi�h whelher speclfied herein or no1. The granting ol e permll does nal prasume <br />In givo aulhodly tn violate or canr.el the piovision ol any olhei stato or local law regulating conslru :lioa or lhe peAormance o1 <br />r,ons�ruction. Thal I am aulhorized by Ihe owner of this property to perlorm lho work lor which apph: alion Is made and I comply wilh ihe <br />Slat� Cq�lrac�s Law 18.27 RCW and 296200 WAC. <br />;n�' `/ ����- -_�`�"_!� % <br />-�� " ��� <br />un �d ��ni i' .:�nlinr 1 n Y�idl•.nivcd AyuN -. _ __. —. Dat <br />