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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.7f PERMIT p <br /> 2�118 Coll, t1�z a��4-��1 , 6 g 10� oo� � , _ ,y, <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER AODRESS CITY2IP PHONE <br /> 5is �•;'c.�y k�l4�;cw„ 2`�1� c�IH,� Fke, s�e �So f,v�.�r1,wA Nazcl <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> 5�cf Mo�� �C.: -��,�+ - ��z� <br /> E-MAIL <br /> �do�k He4r a F���re, T•�. I�b'LI lye �r 3fi �' (5 Mc�roe, w/1 `1d17L `J�J-�]R�}-7`�ib <br /> CONTR.LICENSE M <br /> USE OF 8111LDING I — HEAT SOUHCE I CONTRACT PRICE OF WORK <br /> � C � °_ <br /> I�SF�«- Electric Gas Othcr fs <br /> WORK�ESCRIPT�ON <br /> (�l�ve �� ��re s��+klev� an Qr�oHn, .Iy�►e„� �r'^ �1�v���t i�p.dvcme.-v}. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FlXTUflE OR ITEM N0. TYPE Of FIXTURE OR ITEM <br /> Toilel NC-air handling unils <br /> Datbtub Porced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower 4Yater healer <br /> Kitchen sink 8 disposal Gas lireplace <br /> Dishwasher Gas rangc <br /> Clothes washer Clothes dryer <br /> Water iicater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust lan <br /> Oackllow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking fountain Boiler <br /> Floor drain Refrigcration <br /> Grease trap Woodstove <br /> Roof c'rains O�her <br /> Olher <br /> C�TY OF EVERETT LOCAL SAlES TA%CODE IS 3105 <br /> I hereby ceritity thal I have read and examined this application and know the same to be true and correct. All provisions ol laws and <br /> ordinaces governing this type ol work will be complied with whether specifwd herein or not.The granting of a permi�does not presume <br /> to give aulhority to violate or cancel ihe provision of any other state or local law regulating conslruction or Ihe performance of <br /> consiruction.That 1 am authorized by the owner of this propeAy to pedorm the work for which application is made and I comply with Ihe <br /> State�ornracto/rs Law 18.27 RCW and 296.200 WAC. <br /> i1A `'��'��/ �ti�/���`�� <br /> Signa ":o OwnevConiractor/Authorized Agent f at�— <br />