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SITE ADDRESS <br />�51� 12(..�� <br />LEGAL LO� NO. <br />UESC.( � K{ �( _ <br />�1.� , >�, ,� ��. � <br />l <br />PERMIT ,�-1PPLICATION <br />CITY OF EVFRETT PERMIT SERVICES <br />320U CEDAI� STREET, EVERETT, WA 98201 <br />425-257-8810 - F,1X 425•257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (f `� �C�q' <br />PARCEL TAX I.D. # PERM)IT/ # <br />L « %� 'U � i(J53v C�`( -U�C- �/C- "i7 <br />BLOCK TRACT OR SUODIVISION N i <br />SP� �2G2-��-�7 <br />•nnocee — CITV2IP PHONE I <br />� ��,��.rl t � <br />�.�, uz; Z3S- ��24 <br />TENANT NAIiE �CONTACT FOR PERM T PHONE <br />l 1) �iZ) Z��-S.Sz�I <br />'...� (n •�� . '�Uc.� �U �� � •� E•MAIL ' • ,. .',, <br />� D � <br />I S fa� � r � F-� u .n c � 1 .. . . 1 J�n � /t ' �-I l. . . y / , � Z ) <br />I CONTR. LICENSE p � , K'�� � ✓ � � ,• L`'��l - �' �� <br />. ♦ ' � 7 1 �� <br />, i`r', c,- 1-� ,'l �.`( � 1= �s• L l S iL `i ��C: W A. � <br />— ---- - -- — -- - - <br />USE OF BUILDING <br />�1- IZ <br />HEATSOURCE <br />_ [ler.tric � Gas _ _ Other <br />WORK DESCRIPTION <br />��� �. � �( A Z �}; u' � r- .z <br />NO. <br />PLUMBING <br />TYPf: OF Fl%TUHE OR ITEM <br />-- ---- ---._ _ . . _------------ <br />T utla� <br />l3athlub <br />Lavatory (wash basin) <br />Showcr <br />Kitchmi sink 8 disposnl <br />Dishwasher <br />Cblhes washer <br />\Na�er Iteatef <br />Sink (scroice�badmop/ela) <br />E3ackllow pr�venter <br />Urinal <br />Drinkmy Founlain <br />Floor drain <br />Greasu �r::p <br />Rool drains <br />Olhor - ---_ <br />ICNI <br />CONTRACT PRICE OF WORK <br />�i�,v��' • <br />�'/QLL ���� �-�'�� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />�i�C - air handling unils <br />ForceA air syslems <br />Gas piping <br />Waten c�ater <br />Gas fireplace <br />Gas ranc�e <br />Clolhes drycr <br />Rangc hood <br />Exhaust lan <br />Haal pump <br />Unil healer <br />Boilcr <br />Refrigeration <br />Woodstave <br />CIN OF EVERETT LOCAL SALES TAl( CODE IS J105 <br />� I hereby cerilily Ihat I have read and axamined this applicalion anc know Iho samo lo bo true and correct. All provisions ol laws and <br />� ordinaces governiny Ihis lype o� work will bo complied wiL'i whelher spocilied herein or noL The granliny of a permil does not presumo <br />� to {�ive aulhoriry to violate or canr.el Ihe provision o( �ny olher slate or local law regulatinq consin�ction or the periormanco of <br />� conslruction. That I am authonred by Ihe owner of this properiy to ped��nn lhr work for which applicalion is mado and I comply wilh Iho <br />� Stale Contradors Law�IH27 RCW and 2J6.200 WAC. <br />��� <br />