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PERMIT AF'PLICATION <br />CITY OF EVERE7T PERMIT SERVICES <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPt.ICATIONS ARE ACCEPTED FRUM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRES:' PARCEL TAX I.D. # P R # <br />1i20 \ladiwn Strccl IIO:i ti 1031iI1;S11111 �.�(� l/ 3 Q <br />DESC. <br />LOT hU. <br />tiuuri+e �'ica� Rrlircmcnt Villa <br />BLOCK I TRACT <br />Plcasc xc Shcct :1-? uf Ilic cucluud plau�. <br />ADDRESS CITY2IP PHONE <br />1:i111 �laditiuu Surcl I':cctcu. \YA 9N'2113 ( l'1:i) 3:i;i-III III <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />\'eiizuu\l'ircics> Rc:dCuinAssui'.-S:u�ah�l�cl+rhu�c �l'2:i'?7�1-6111cz1.111 <br />I�113`154: l:;u��;atc \Yap Sui�c YIiO 1lcllc�vc, \\'A 9RI1117 <br />CONTRACTOR ,�,�;�� ADDRESS CITY2IP PHONE <br />CONTR. LICENSE p <br />USE OF BUILDING <br />Conmicirial/retail <br />WORK DESCRIPTION <br />HEATSOURCE <br />N/:\ <br />Electric Gas Othcr <br />CONTRACT PRICE OF WORK <br />S I:;.uou.ou <br />Plcasc+ccrucluxcdPrujcclllcxcriptiuuli�rmuredcl,�il�•di�d��„��:�ii„��. Rep\u�e O�'Y�I) extsi�r�micrawa�Utsr� <br />Gr�c1 re 1aui� i o i ne �l ow� r. <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cblhes :�:asher <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Back(low preventer <br />Urinal <br />Drinkin� Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />m <br />TYPE OF FIXTURE OR ITEM <br />A/C— air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS J705 <br />I hereby ceritify that I fiave read and examined this application and know the same to be irue and cortect. All p!ovisions of laws and <br />ordinaces governing this type of work will be complied wilh whether specifed herein or not. The granling of a permit does not presume <br />lo give aulhority to vk?I�te or cancel lhe provision of any other slate or local law regulating wnsWclion or lhe performance of <br />constr{�ction�That�l �m authorized by,the owner of this property to pertorm ihe work for which application is made and I comply with Ihe <br />Stale Contr`a�tors;6ew,1827 4CW and 296.200 WAC. <br />`�z <br />