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i <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERF_TT, WA 98201 <br /> 425-257-8810- PAX 425-257-8857-www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> ��C�/ A � rM..� w•� ncy38 �z33do 'z9oo S S/a -DU <br /> LEGAL LOTNO. BL K TRACT <br /> DESC. <br /> OWNEn ADDRESS CITY/ZIP PHONE <br /> �'iace,ufiNi �o��Sct �co 13cL �n� �;�� Z,oul- G'F� .¢� S 5�'t-/�f� <br /> TENANTNAME CONTACTFO PERMIT PNONE <br /> L� ccl� � GASN �'IGUG �Lo�� 1 4��- 776--5835" <br /> CONTRACTOR �Gf f N[UN �O ADDRESS CITY2IP PHONE <br /> r Zqoo N.� r�.l•s�� n� y:z�_ „�--8's3s- <br /> CONTR.LICENSERBLf��/�1/CO'j7C.M �UG �C 3 <br /> i f� l�� 1�12v <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric _Gas Other � /s.3, ��' <br /> WORK DESCRIPTION '� <br /> /n+.S�fqLL C/) 5�-4- oF ��.� C��\NN. L Lc�crS <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathtub Forced air systems <br /> Lavato�•(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas reng�� <br /> Cbthes washer Clothes dryer <br /> Laundry tray Range hood �, <br /> Sink(servicelbar/mop/etc.) Exhaust lan <br /> BackAow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodslove <br /> Ruof drains Other <br /> Olher <br /> I <br /> � CITY OF EVERETT LOCAL SALES TAX CO�E IS J705 <br /> I hereby centify'hat I have read and examined this application and know the same to be true and correct. All provisions of�aws and <br /> ordinaces governing this type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br /> to give aulhordy to violale or cancel the provision of any olher state or local law regulating construclion or the performance of <br /> construction. That I am a orized owr.er of this property ro pedortn the work for which application is made and I comply with the <br /> State Contrectors Law .2��.200 WAC. <br /> /e 7 -oy- <br /> Sign f euContractor/Authorized Agent Date �i <br /> - -- — � <br />