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PERIVIIT !�P'PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />LOT NO. BLOCK I TRAC7' <br />DESC. <br />Gf� <br />TENANTNAME <br />CP'�1c�J CP�2� ' <br />PARCEL TAX I.D. # <br />FERMIT # <br />� b5// - 0/ <br />CONTACT FOR PERMIT PHONE <br />cS�Tc��n�wlar�S 2-�-�f52-C�11� <br />CONTRACTOR ADDRESS CITYI.'.IP PHONE 2�_Q�,� <br />�.%(�lCST�I�t� �lGl�i i245WG�TLAtc� �l�E 1.� c5�4iqi"L�L�� v��- <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEATSOURCE <br />_ Eleclric _ Gas <br />CONTRACT PRICE OF WORK <br />� q n <br />Other �" ��) J <br />WORK DESCRIPTION <br />I rus-r�- ��iG n�� � I 1v�an� � nn��' D� F 5 i G N ���i= (.Jr��.. <br />��Gl� -rENc�+�T' � O� t s f� WAc� b�Gt`l C�aDP.C-,�5, <br />NG <br />NO. I TYPE OF FIXTURE OR ITEM <br />7oilet <br />Balhtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry lray <br />Sink (service/bar/mop/etc.) <br />Backllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR I� EM <br />A/C—airhandling unils <br />Forced air systems <br />Gas piping <br />lVater heater <br />Gas f replace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woadstove <br />Other <br />CIT' OF EVERETT LOCAL SALES TAJC CODE I!'i 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming this type of work will be complied with whether specified herein or not. The granting o( a permit does not presume <br />to give authority to violale or cancel lhe prwision of any other state or local law regulating consWction or the performance of <br />construction. That I am aulhorized by lhe owner of this property to perform lhe work (or which application is made and I cam�dy with the <br />State£�ntrarinrs#avr1B.27 RCW and 296200 WAC. <br />�� -2� -�5 <br />