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SI7E ADDRESS <br />(oo I !J P�(�oA <br />DESC. <br />P�FiMIT APPLICATI <br />CITY OF EVERETT PERMIT SFRVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICAiIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. p <br />EveK�'�,wA 1g2oi 2°loSl�oozl49 <br />EvEP-�rti" �M MU N c[�{ C.�u.�i�E 2ooD TouJ �� ST. <br />TENANT NAME CONTACT FOR PERMIT <br />��� Wll,��, � <br />x <br />L�EutENulhl, CUvtgPGtt{2S ENtE��'f��S�S, 5113 l'AG►F� htNr( �, FIFE,Wp� <br />CONTR. LICENSE p ( NG. <br />r��i-rFr.Eoo4� SrE 1 °�842¢ <br />USE OF BUILDING <br />T�M?oF+�Y arH�Ec�r. PRn�TI�� <br />WORK DESCRIPTION <br />��'� GoNK�P�1"�of�JS <br />HEAT SOURCE <br />/�Eleclric _ Gas _ Other <br />PERMIT 8 <br />P, 90 ; - <br />< <t�7A� 47x ^ <br />206 • �e24' 2177 <br />253�°(2�-t�1v <br />tACT PRICE OF WORK <br />(�5, 3oa <br />o�NIN(i� IN �jCI�T�N(� WPd.I. � T��� 5{j�,ag� U�!(S', <br />p�oM �K IS1"�N(� $uIIDIN V • <br />� S C s�F <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />Back(low preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />N0. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas firep�ace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity that I have read and examined this application and know the same to be lrue and correcL All provisions of laws and <br />ordinaces goveminc� this rype of work will be complied with whether ;,,ecified herein or noL The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other st�:e or local law regulating construction or the performance of <br />cons uction. That I am aulhorized by the owner ol this property t� perlorm the work for which application is made ar.d I comply with Ihe <br />State itractors Law 10.27 RCW and 296.200 WAC. <br />r � <br />J <br />Signa re I Own dContractor/Authorized Ac+�nt Date <br />I- <br />�� <br />