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�r�ERMIT APPLICQ.� ION <br /> . CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7', WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everPttwa.org 2_d 3,�s <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBiT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITEADDRESS Hp��� (YN'� �tl�✓Cl'� PARCELTAXI.D.N RMIT/ <br /> �jlD� P1r+e sC�'eet , �de,rttt ���20� 0043ao'} g000lao � �� - Q3� <br /> LEG L07N0. BLOCK TRACT - <br /> oesc. �ty t-3o 6►�c �}90 a•� �ts I-il a� 2�-32 ��ck '�53 E�arr I.aw�a Co. �'►+�T rad�t� <br /> OWNER ADDRESS C 21P PHONE <br /> WPPQ lhJCs?m9v�7Z, �l.0 lq2�i5 86�^A�a�w►e S. Ke�T. WA 9�oi2 2*�3 SaZ-lq <br /> TENANT NAME C ACT FOR PERMIT PHONE <br /> f�liday �nr E�ereR I ue,►�e�y�tS�Deq�brr. PiA �b 62; 6368 <br /> CONTRACTOR RESS . CITY2IP PHON6 <br /> N►Crit CompNn� 3020 Gb'"9treei L�Ken�.boa , Uf�• °I84`t°I 2h3 5�-q�oo <br /> CONTR.LICENSE�1 � <br /> rhe�'i t *�3"fi l N 8' <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> h(,'aT urn S $1 2D0 000 <br /> t�fie 1 _e���� ��e�_d�ne� � , <br /> WORK DESCRIPTION _ _ <br /> patevn�►u�-� �o ewstw� hotel t�lu4�� r�evti► f rep��cew�e►,t of Por+�e cactiere , <br /> al?�at►ans 'fi Lpbhy , CX�t'trier �„c�uulwKj new �fapCt � cornices , Chclos�.�a of <br /> C ►S1'in AriO ec a�cli}�ar-+ o� �'2- !SW GA►�o .25 qt Cbn�el��! Ctn'�Pr• <br /> PLUMBING �t �„��A �� MECHANICAL �, �,��Id <br /> NO. TYPE OF FIXTURE OR ITE ��S Q NO. TYPE OF FD(7URE OR I YL._I., .�i5 <br /> W!� <br /> _ Tollet A/C—air haodling units q�f• <br /> 8athtub Forced alr systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Weter heater <br /> Kitchen sink&disposal Gas ftreplece <br /> Dishwasher Gas rande <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> � Urinal Unit heater <br /> Drinking Fountain Boller <br /> Fioor drain Rufrigeratlon <br /> Grease tr.3p Woodstove <br /> Roof drains Other _ <br /> Other _ <br /> CITY CF EVERETT LOCAL SALES 7AX CODE IS 7705 <br /> I hereby ceritify that! have read and examined this appllcaUon and know the same:o be true end cortect. All provislons�f lews and <br /> ordinaces goveming lhfs type of wor';will be complfed with whether specified herein or not The granGng of a pertnit Coes r,ot presume <br /> to give authority to v�:�iate or cancel the provision of eny other state or local law regulaUng consWctlon or the performance of <br /> wnstruct n.'!hat I am aulhorized Dy the ownar�f this property t� perfor,n the work for whlch applicatlon is mede end I comply with the <br /> State C ra o aw 18.27 R(.'W and 290200" "'. <br /> i�ti O <br /> S gnaNre o Owned Vactor/Authorize Agent ate ��Z <br />