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_ _ _ _---- <br />F =RMIT APPLICATI.. �: <br />CITY OF EVERETT PERMIT SERVICES <br />� 3200 CEDAR STREET, EVER[TT, WA 98201 <br />�� 425-257-f1810 - rAX 425•257-8857 - w.vw.everettwa.o�g <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM • DEBIT � CREDIT CARDS ARE NOT ACCEPTED <br />I SITE ADDRE_�S <br />L[GAI LOT NO. <br />UESi,.I .f' ,� <br />c�' �c <br />l.� <br />T[NANTNAME <br />'`� � S � C �� <br />�OCK <br />CON'RACTOR <br />r�vli4�{� /�(<.�.��f z`�,` <br />CONT;i. LIC[NSE p , <br />--��a�� �_/_7� /� 'T —.— <br />USE OF UILDING <br />S /- !L <br />-- ---------- ------ -- -- <br />WORK DESCRIPTION <br />PAR�EI. TAX I.D. # <br />OC7 s3 y-c1Qc,. �yy" 1� � <br />TRACT <br />� : : - . f , ` /. . <br />?�n�'_ ✓t� �S'c}X : <br />CON7ACTFORPERMIT <br />ADDR[SS <br />J 4 ���--Q <br />HEATSOURCE <br />_ Clec�ric X_ Gas _ _. Olh�•r <br />� -__'--- :_ ) '�. C / i_. -�� <br />PLUMBING <br />� NO. I TYPE OF FIXTURE OR ITEM <br />� i ToIICI <br />� f3a�hlub <br />j ,� Lavalmy (wush basln) <br />; Showa <br />: _ 7 Kitchen sinh 8 disposol <br />'� _ i Dishwashor <br />/ Clothes washer <br />i _._ L:nindry tray <br />_ Sink (sorvir,elbadmuplutc.) <br />_ �ar.kllow pravonlor <br />Urinal <br />� _ Drinkinc7 Foun�ain <br />� Flour drain <br />�� Grease irap <br />Roo� drains <br />I Olher <br />f^ <br />��0. <br />CITY/ZIP <br />PERMIT p ! <br />CoSc�- o�{L ' <br />�� --1J�—Z -� b�v9 <br />PHONE <br />fHONE <br />i CONTRACT PRICE OF WORK <br />0 <br />-----/ S .G�Ci--- <br />MECHANICAL <br />TYPE OF FI%TURE OR ITEM <br />A/C -- air handlin� unils <br />_/ Forcrd air systems <br />� Gas pipinq <br />_[_ Water healer <br />� Gas liroplaco <br />Gas range <br />7 Clothes dryor <br />_� Ranpo hooJ <br />Fxhaustfan <br />Heat pump <br />Unil heatcr <br />_ Boiler <br />_ Rofrigaration <br />Woodsluve <br />Olher <br />i CITY OF EVERETT LOCAL SALES TA% CODE IS 9105 <br />I herehy aarilily thal I havr read and examired Ihis application and Anuw Ilie same to I�a true and currecl. All provisions uf laws anA <br />„rJinacns �o�;r,rnin� Ihis lypa of work will bo complied wilh w'ie�her specilieJ herein or not. The gr�nling o( a permit does net presurt�e <br />b, givo aulho�ily lo viul:de ur canr.el Iho provision ol any other stale or local law re�ulating construction or Iho pertormance ol <br />, �����ns�ruction. That I a�n authoiizad by Iho own�r ol Ihis propert�� lo perlunn tho work lor which applir.ation is made and I comp�y wilh the <br />� Slate Contra��lors Law iH.27 RCW arlff 296.200 WAC. �• <br />� � ti�k S� "� �s-- <br />`���1���a� 1 Own �,onlracfod uthor gent il�• <br />� �'r ,� � ,�� � <br />I <br />� _ _ . . _.. -- - . . ._. ._--- - ------�-------__— 1 <br />