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_il�o6 <br />---- -- -v <br />PERMIT APPLICAl'ION �y�, ►�- �,° � <br />CITY OF EVERETT PERMIT SERVICES /l� � � <br />3200 CEDAR STREET, EVERETT, WA 98201 ,� v � —7 � <br />425-257-8810 -- FAX 425-257-8857 — www.everettwa.ory O � <br />SITE ADDRESS � <br />ILEGA � LOT NO. <br />DESC. <br />TENANTNAME � <br />ec7 oyd?�C <br />CONTRACTOR `� <br />J <br />CONTR. LICENSE p <br />LL <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� SU/ <br />BLOCK <br />r <br />PARCEL TAX I.D. p <br />l2� �4/ 0/�! �o�s <br />7RACT <br />FOR PERMIT <br />e <br />PERMIT p <br />(3 0�;, 0 3 <br />CITY/ZIP PMONL <br />�. N� �;� /�d, �vA.�o� <br />PHONE <br />USE OF BUILDING I HEAT SOURCE <br />��aNv7B�`��IN g 1 _ Eloclric � Gae --- Olhcr <br />WORK /DESCRIPTION / n <br />/ ���1 %D��'Z3 � li�SfG�.IU� P'[oawt <br />�i��lZ�X26,S� �HfI�/ePriay <br />r.u�ir��x.�a��:K�uax.�caiias <br />Toilet <br />_ �ath�ub <br />Lavaiory �wash l�asin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwashcr <br />Clolhes washer <br />Watcn c�ater <br />Sink (sr.rvicc/barlmnpictr..` <br />_ Dacklbw preventr.r <br />Urinal <br />Drinking Faunt�in <br />Floor drain <br />Greaso Irap <br />Roof drains <br />Othe� <br />��S <br />� c✓ - ��✓ - <br />CITYIZIP PHONE <br />yd�( 2 <br />���s�iH� <br />CONTRA(;i PRICF: OF WORi( <br />�3G, aa `' -- — <br />v�eti/Hy5 iK <br />r,�a I/ <br />N0. I TYPE OF FIXT�)RE OR ITEM <br />NC — air handliny units <br />Forced air syslems <br />Gas pipinc� <br />Waler healer <br />Gas lireplace <br />Gas ran�e <br />Clothes dryer <br />Ran�ehood <br />[xhauslfan <br />Heat pump <br />Unit heator <br />Boiler <br />Re(riperation <br />Woodstove <br />Olhor _ <br />CITY OF [VERETT LOCAL SALES TAX CODE IS J105 <br />I hereby cerilify Ihal I have read nnA examined ihis �pplicaiion and hnow the same to be Uue and correct. All provisions of laws and <br />ordinaces govorning Ihis lype o( work will be complied wiUi H�helher specified herein or nol. �ha grunling ol a permil does not presuma <br />to give authority to violate or cancel the provisiun of any olher slate or local law regulating consiruclion ur the periormance of <br />construclioa Thal I am :wthorized by Ihr. owner ol Ihis property to perform Ihe work for which application is made and t wmply with tho <br />Slaln.Conlracld(slaw 1�.27 RCW and 296.200 WAC. <br />2 -2 y-d <br />'/z <br />