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i / / �.' / <br />SITE ADDRESS <br />Lf:GAI� LOT <br />nesc n • <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 CEDAR STREET, EVERETT, V1'A 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />" PARCEI TA% I.D. M PERMIT M / <br />�a�ea►��� 5'73g-000-0'7� b13-�I�i�l�r (%'' <br />D. ULOCK TRACT # <br />•'%3 QY1 D-OO S�LVLi�, � 3 <br />NoV�s�� �t/�t-aprriowt�si.c_ <br />TENANTNAME <br />N�k <br />CONTRACTOR �O HE U���N-M'N`�U <br />CONiR. LICENSE I <br />USE OF BUILDING ,S�N3 ��. Fp�ry.� �.� <br />ReSiG�e�a1 CLou��n:u;w: <br />aoor+Ess cmmr PHONE qu-g51-Io110 <br />tp2rs �a� avE s �� w� �so3Z <br />co�crFoueR�F�b4��r y25 �N[�Sb- 7Y3S <br />� <br />ADOF[SS <br />CITY/ZIP PHONE <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />� �$r' <br />_[Icctnc ✓G.�s_OBicr ,�����• �7 <br />WORK DESCRIPT�ON . , . <br />-�D CoNsrn,u� 1 S;,uGcc -�,am;cy .DQ��reA CouDon�� Mkw� uu�T <br />PLUMBING <br />NJ. I TVPE OF FI%TURE OR ITEM <br />_� Toilet <br />� �athtub <br />�_ Lavalory (wash basm) <br />� Shower <br />� KAchen sink 8 disposal <br />__�__ Dishwasher <br />� Clothes washer <br />� Laundry t�ay <br />_f� Smk (service/badmopletc � <br />Backflow prevenler <br />Unnal <br />Dnnkmg Fountain <br />Floor drain <br />�Grease trap <br />Rool drains <br />Olher <br />TYPE OF FIXTURE OR ITEM <br />A/C - air hand6ng unils <br />Forced au systems <br />Gas pipmg <br />Water heater <br />Gas Greplace <br />Gasrange <br />Clothes dryer <br />F2an.,e hood <br />Fzhaust lan <br />lieal pump <br />Und heater <br />Boiler <br />Rehigeralion <br />Woodstove <br />Other <br />CITY OF EVER[TT LOCAL SALES TA7( CO�E IS �105 <br />I hereby rcrt§fv Ihat I have read and eKammed this applicahon and know �he same to be true and corted. All provisions ol laws and <br />ordmaces goveming this lype of work vnll be complied with whelher speafied herein or not. The grenling ol a permit does not presume <br />lo give authonly to wolate or cancel the provision of any olher state or local law regulaling constructioa ar Ihe perlortnance ol <br />constr hon Thal I am authorized by �he owner ol lhis property �o pertorm Ihe work lor which appGcation is made and I comply with the <br />Slate��Ira�tors�Law 18 27 RCW and�?�0 WAC. <br />L <br />