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P'�RMIT APPLICATI(��� <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 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS cPG�/ � � '�O�j� PARCEL TAX I.D.# ERMIT# <br /> �/`�/`I /If�7 .�lYP. SE. �� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> TENANT NAME CON'fACT FOR PERMIT PHONE <br /> /�/D ft'/.�A'lf C� P/�'/'E�7` �/%� �7'� a2��i�0 `fs5^�9�96�9' <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE <br /> Mcn�viy �i�i��/er Cb./�e. P,p.�cvc �� �:s ^Yr99- 9�q <br /> CONTR.LICENSE�E�CU,PC �2�yE �2/�� / �D4� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric _Gas_Other 12�.�� <br /> WORK DESCRIPTION . � � � �/r�� �� <br /> li11 ft//� �`��/Y/���" �1'/� f 7�/b Ov7` /� <br /> ��c�J/ ��9�. 9 s�rr��/�"J ��/. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handlinc�units <br /> _ Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Cblhes dryer <br /> _ Laundry tray Range hood <br /> Sink(service/bar/moplelc.) Exhaust fan <br /> BackOow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> F�oor drain Refrigeration <br /> Greaselrap Woodstove <br /> Roof drains Other <br /> Other <br /> CI�Y OF EVERETT LOCAL SALES 7AX CODE IS 3705 <br /> I hereby ceritify thal I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces governing lhis type of work will be complied with whelher specified herein or nol.The granting of a permit does not presume <br /> to give authorit lo vi la[ebr cance Ife provision of any olher state or local law regulaling construction or the performance of <br /> constr hat m �t i by,the owner of this property to perform the work for which application is made and I comply with lhe <br /> Sta r a � '7� � . 00 WAC. <br /> ,. re.r. 8�9 OS <br /> gnature of Owned ntractodAuthorized A nt Date <br />