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L3 ��8/O � 0 3 6 <br />I—cRMIT e4PQLlCATIuN <br />CITY OF EVERETT PERMIT SEf2VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />SITE ADDRESS <br />8S/ N ���d,.. <br />l EGAL LOT NO. <br />APPLICATIQNS ARE ACCEFTED FROM 8 Alr'i i'O 4 PM <br />PARCEL Tv,JC i.D. # <br />-2ni�5 /J?�G2�O�G0 <br />TRACT OR SUBDIVISION M <br />PERMIj-JI <br />�; Vi a� � / � �- a-- <br />/a'toon �Lia.�ay yu/J 7� ��`f % <br />TENANT NAME <br />� ' I CONTACT FOR PERMIT PHONE y2 S 330 .? rz� o <br />..S tibc,.a <br />2�/��f" �i^ / <br />iVl\IRMVIJR " • <br />'�`�'J�-t.� /l4eGG,a„rzu ( 5�1..,�ion �S �32G -/�� 3��r.e�`� <br />CONTR. LICENSE # �� �`p'�S— <br />�rM��s�-is 9S.2CiT� <br />U$E OF BUILfIING ( HEAT SOURCE CONTRACT PRICE OF WORK <br />00 <br />��dw `� �o� ��Electric _Gas_Olher c �.2�Uoo <br />�jZs �3Q _2�30 <br />WORK DESCRIPTION <br />/1e...e,J.� �/kt�`� %�„�3.�T�^ �/ctf ��n1�i•r?e�l.�re <br />�'lSt���'i� /L�/AGL �.Ei�d/-�/i�c(p !-!ei"�{��� !/NGt ��i-Y�? <br />1��>` �y�''l�ir-,. Qa� Ne�✓ /1�5%�a.�., CX�4. % i+n• <br />N0. I TYPE OF FIXTURE OR ITESd <br />Toilel <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Disliwashcr <br />Clolhes washer <br />Waler healer <br />Sink (service/badmop/elc.) <br />BzckOow prevenler <br />Uiinal <br />Drinking fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />4%fh �/��1 //�4q� <br />w. ��i f�c�EfH+e/A/ <br />MtG <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />1Voodslovo <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby ceritify that I havo read and examined this application and know lhe same to be lrue and correcL Ail provisions of laws and <br />ordinaces governing lhis lype ot work will be complied with whether specifed herein or nol The granting of a permil does nol presume <br />to give aulhoriry to violale or cancel the provision of any other state or local law regulating consWclion or the performance of <br />construction. ThaN�mJ authoiized by the owner of lhis property to periorm the werk (or K•hich application is made and I comply with the <br />Rtate Cnnt�actors La�i 18.27 RCW and 296.200 WAC. <br />/�j� y,/o,� <br />