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SITE ADDRES.�, <br />I�� uor�-r� <br />LEGA LOT N0. <br />DESC. �, <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. A <br />Y �4v�• 2qo�,t�ooza4 <br />BLOCK �— TRACT GR SUBDIVISION il <br />�pz�`fi Ct�MMNNITY G�� 'L�� ToW� �� <br />TENANT NAME <br />�IE�µU�R- t,� 1RtKiit U+ur�crt <br />l.VR111tN1.1 VIf <br />����� <br />CONTR. LICENSE X <br />USE OF BUILDING <br />!'�i�Mf31.H G��1 f' � -3 <br />HEAT SOURCE <br />r: <br />�Y�i't- 982DI -0I2s 3 <br />_ Eleclric ,� Gas _ Other <br />PNONE�'�,252•ZI�i3 <br />u�wn 4�/�1l.'7.��1Wf%11T�MMl: <br />CONTRACT PRICE OF WORK <br />��o, ao0 "� <br />WORK�JESCRIPTION -ra-+a.,,-r rNtpr�v�M�-rrT� �"� rS N�J�I �l'h'<<�'�• WIL�-��N1 <br />f�v�yiNW -Cr� ou-v�P�u�a� `nt� sn� �r-�t h G�uP M To � <br />GrtzouP l4-�. wiu, A+_.5o Qucr� u�t�c��r�c� 'CN� coustrzuc.-noH 'r�lP�� <br />o� -clt� �Pht� �M �'l #'� �'P� T� TH P�; �k-� • <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toiiet <br />8alhlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dish�vasher <br />Cblhes washer <br />Water heater <br />Sink (service/badmop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Root drains <br />Other <br />,� <br />TYPE OF FD(TURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firepiace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heeler <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3705 <br />I hereby ce�itily that I have redd and examined Ihis application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming this lype of work will be cortiplied with whether specilied herein or nol. The granting of a permit does not presume <br />lo give authority to violate or cancel ihe provision of any other state or Iocai law regulating construction or the perlormance of <br />construction. Ty(at I am author zed I:e owner of Ihis property to perlorm Ihe work for which a�plicalion is made and I comply with the <br />State Contr�t�Ors Law}t4)27 a 29.6.200 WAC. <br />`rZ <br />