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P`RMIT APPLICATI(,.J <br />CITY OF E�/ERETT PERMIT SERVICES <br />;5200 CEDA.R STREET, EVERETT, WA 98201 <br />! 425-257-8q10 — FAX 425-257-8857 — www.everettwa.org <br />SITE ADDRESS <br />� �-� � C;-1��� <br />i FG� LOT N0. <br />C hw��'w,� <br />�' 1 UUb <br />TENANTNAME <br />APF'LICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />pARCEL TAX I.D. A <br />j�1 � l � �C0 3c+17 C°dJa )•�.J�Q— <br />� � l. (�� .3_�.QUc' ' 7. i 7� <br />BIOCK iRACT OR SUBDIVISION N <br />�,��o,} �;euu:-�r H�� rN�u"s D �� � <br />ADDRESS CII�'/121P <br />,jcJNNiT�n.1 7�;;� �- 4J�n1A �i 1� LU�YCT� <br />..- i rN i 1 � tl'V1� C_� i�`. .— 4V f'�! <br />CONTRACTOR /1) y n ✓ <br />iv�' <br />CONTR. LICENSE lt <br />USE OF BUILDING <br />�? �SI I l�_��L <br />WORK D[SCRIPTION <br />C;.T I '> � � N(r <br />��c�z� �U <br />--- — PLUMBING <br />NO. I TYPE OF FIXiURE OR ITEM <br />Toilet <br />�athtub <br />Lava�ory (v�ash basin) <br />Shower <br />Kdchen sink R dispos�l <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (servicelbar/mopletc.) <br />dackllow preventcr <br />Urinal <br />Unnking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other — <br />�CONTACT FOR PERMIT <br />�tj�vf(Xt'�'�% ✓C�/��'��rilli <br />HEATSOURCE <br />� Electric _ Gas _ Olher <br />i��:�dil ���� <br />PHONE <br />__ i <br />� �aJ-iz <br />PERMIT it <br />� C<-� // o(r - oo / <br />HONE <br />41t=��3-�t'94 <br />�Z"s ��3-3>"99 I <br />. I �)VIY� t7�i'� )!10 9l <br />_ C <br />CONTRACT PRICE OF WORK <br />`_ . <br />, <br />C-��rt'�}.; > > <br />— — -- MECHANICAL <br />N0. I TYPE OF FIXTURE OR ITEM <br />� NC �- air handling units <br />� Forced air syslems <br />Gas piping <br />Waler henter <br />Gas fireplace <br />Gas range <br />Clolhes drier <br />Range hocd <br />Exhaus� lan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br />. I hereby certily Ihal I have read and eaan�ined this applicalion and know tho same to be true an] correct. All provisions ol laws nnd <br />Iordinances govenung this type ol work �•nll bo complied wilh whether specified herein or nol. llia granting of a permit does not presume <br />lo give aulhordy �o violate or cancel Ihe provisio� of any olher state or local law regulating construction or the performancc ol <br />� construclion. Thal I am authorized by Iho owner of Ihis property lo periorm Ihe work (or which aGPlication is made an,i I comply wilh the <br />Slyde ConUaGlprs LTw 18 27 RCW and�'J6.200 W�C. <br />_ •,.3-� <br />oa�e '/ <br />l2 <br />_ I <br />