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?2�3 <br />PERIVIIT APPLICAYlON <br />CITY OF EWE�rETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPS.ICATIONS ARE ACCEPTEJ FROM 8 AM TQ 4 PM <br />SITE ADDRESS , <br />w� � �, s�- <br />LOTNO. BLOCK <br />5�.,�ws� 1%�e� �e��v� �i�l.�u, <br />TENANTNAME <br />�i�P�f+'ZV �lV'ej <br />CONTRACTOR �'L%� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />n �e�3c� � <br />TRACT <br />ADDRESS <br />2.6�D Wlc�kOwSrt <br />CONTA�� P�O1R PER���N <br />R <br />_� .� <br />ADDRESS <br />HEATSOURCE <br />� Eleclric _ Gas _ Other <br />5-o a- -0 6 <br />`�� I PE MIT # �, <br />������ <br />CITY2IP PHONE <br />�i J �Gve�.t�lZ4� <br />PHONE <br />3�-t�o�-�� <br />CITYIZIP PHONE <br />ICONTRACT PRICE OF WORK <br />1�,���� <br />1NORK DESCRIPTION �_��G�� ���X��S.�\�15 C�LL '�pt,(7 ��/`� t.C�.U,�� <br />\A.� G 1� � l� C� wL��Qls�-^n1;�L � <br />N0. <br />��; <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavarory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry Uay <br />Sink (service/bar/mop/etc.) <br />Backfiow preventer <br />Urinal <br />Drinking Fountain <br />Floer drain <br />Grease trap <br />Roof drains <br />Olher <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �705 <br />I hereby cerilify that 1 have read and examined this application and know the samo to be true and wrrect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give authoriry ta vio cancel the provision of any other state or local law regulating construction or the performance of <br />const on. That I a autho zed by the owner of this property ro pedorm the work for which application is made and I comply with lhe <br />Stata�or�[ractors Law 8.27j�CW and 296.200 WAC. <br />(' <br />� <br />