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1 <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 r <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org �cU <br /> APPLICATIONS ARE ACCEPTED FROhi 8 AM TO 4 PM �� _�- 07 <br /> SITE ADDRESS PARCEL TA7C I.D.p PERMIT/f <br /> Z�ral WcTt-�eprq„c. Ev�aarr, WA 5a2o1 �O4?tTltoll000loo ��7� - � <br /> LEGAI, LOTNO. BLOCK TRACT <br /> DESC. � I �7„���� (02< � <br /> OWNER ADDRESS CITY2IP PHONE <br /> �hNM ��Ner r�o N 8�.rlin�far� Slvd. �•rl�v�4m 98Z33 <br /> TENANT NAME 'pq�j(�'-� a �,/ CONTACT FOR PERMIT PHONE <br /> •tr�'�+•t-�a��. ICa��-4al }'�-rcbi��ct't�--� �12r-3��I-Bo[7 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �WAItR_ <br /> CONTR.LICENSE M <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> a4.'L:cr _Eledric _Gas_Olher ��D�� <br /> WORK UESCRIPTION <br /> r2 e+ti'tveow�-1 'b be� adckt> ovl -�t�'+?.—�l.ee�rS .. <br /> �o��C '. �i . . <br /> PLUMBI G � ' � ' MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIICTURE OR ITEM <br /> - . <br /> !o Toilcl A/C—air handling units " ' <br /> Batht Forced air syslems <br /> y Lav ory(wasli basin) Gas piping <br /> S wer Waterheater <br /> 'chen sink&disposal _ Gas firoplace <br /> ishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Waler heater Range hood <br /> Sink(scrviceNadmop/otc.) Exhausl fan <br /> Backflow prevenler Heat pump <br /> �_ ' al _ Unit healer <br /> Drinkin n Boiler <br /> _ Floor drain � Re(rigeration <br /> Grease trep Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify thal I have read and examined this applicalion and know lhe same lo be true and correcL F,II provisions of laws and <br /> ordinaces c�oveminc�this lype of work�vill be complied with whelher specified herein or not.The grenling o(a pertnit does not presume <br /> to givo authority to violale or cancel the provision of any olher state or local law regulating construction or the pedormance oi <br /> construction.That I am aulhorized by lhe owner of this property to perlorm the work for which application is made and I comply with the <br /> Slate Centractors law 18.27 RCW and 296.200 WAC. <br /> 'I.�t.tA �� (o- 2fo-o7 � <br /> Sigralure o(OwnedContraclorlAulhonzed Agent Dato Z <br />