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. '� <br />� PERMIT APPLICATION <br />CiYY OF EV�RETT PERMIT SERVICES <br />:'s�00 CE�A?i STREET, EVERETT, WA 98201 <br />425-257-88? 0-- Fr.X 425-257-8857 — www.everettwa.org <br />0.PPLICATIONS ARE ACCEPTED FRO�JI 8 AM TO 4 PM <br />SITE ADDRESS <br />I tx� I � +�+ <br />LEGA LOT NO. <br />DESC. �j <br />CoMt�U�h;�r Coc�.�� <br />PARCEL TAX I.D. N <br />�10 , i7�x•7�147c <br />TAACT OR SUBDIVISION • <br />C�(il' oF �lcRr_ <br />ST. , �vc,2t�f, W�- <br />TENANT NAME �� CONTACT FOR PERMIT RY� ��. i, .i PH,ONE <br />I /iT7At�1 Cc.,�ry v� ^wtt�►tl <br />M�'�s�c�.lE-e.-�c�Fi�T�� C�i�f���. 2�i2,NLc�li�rc=c��G e.MN� <br />��% �JfJ�JT�Iir� <br />CONTA. LICENSE N D v��� V G q�J Z <br />USE OF BUILDING <br />���MgjL` <br />WORK DESCRIPT�ON <br />y'C2���('� R,lhL <br />�'-�M P� i �Y� <br />J� <br />Af $`1u'�iz5co2 <br />�7'XJ dEu���M�c,�µn P� N1�.1 <br />•I U�-/k��P.I�A HJL�I'')o� <br />��bS-`l ioa <br />S 2SZ - Z I S3 <br />aJ � 7.15� tA ac.��� n.uu <br />ca� <br />2�/!o%I/ <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric # Ga; _ Olher �� 20� Dp0 <br />vP�� r� ExiSTi�.s� �l1lW�r�6 To cRT��-� � <br />�l <br />NO. I TYPE OF FlXTURE OR ITEM <br />Toitet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washcr <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Irap <br />Rool drains <br />Olher <br />GOM'PLIPvJG� , <br />N0. I TYPC OF FIXTURE OR fTEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireptace <br />Gas range <br />Clothes diyer <br />Range hood <br />Exhaust tan <br />Heal pump <br />Uni� healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAI( CODE IS 3105 <br />I hereby ceritily tliat I have read and examined this applicalion and know the same lo be true and correct. Atl provisions of laws and <br />ordinaces governing ihis type o1 work will be corr�plied with whether specitied herein or not. The granling of a permit does nol presume <br />to give authority to vioiate or cancel lhe provision of any other state or Iocal law regulating construction or Ihe perlormance ol <br />conslruction. Thal I ain authorized by ihe owPer ol this properly to perlorm Ihe work for which applicalion is made and I comply wlih Ihe <br />State Cpiptractors La�v 18,�f C1y and 2�8:200 WAC. <br />P }-Rn) E <br />ZL•Y'L A ✓.'-� <br />I�Z <br />