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47 -03 -0 <br /> PcRl1i'tIT APPLICATIUN <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 /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS .7- PARCEL T/U(I.D.# PERMIT N <br /> ?- L�'c�f C'<<�, �t�� R'�,,,�L Zf'n�-l/3��r��v ,�iu�� �7"G55 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> � v < ii� l�- Y�i�i� (� LL (� 1.��'� (cai�a� SE � k.� /i�.. �f/ 1673�I <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �j.ilh� ������ �<C6,�.� Z`I - 7J`70 <br /> CONTRACTOR /��„��. � � ADORESS CITY2IP PHONE <br /> .� - / 752L r3rll�tN6cJ.,�� �-'C,�t�. (� <br /> CONTR.LICENSE N � � �,��5 , � <br /> iN� iTRt `1S.5�Cr re� rl��/r ��'/� r�Y� il ) `/8`I siv� <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleciric Gas_Olher <br /> WORK DESCPIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilol A/C—air handling uniln <br /> Bathtub Forced air sysloms <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Waler heator <br /> Kitchen sink 8 dis�x�snl _ Gas fireplaco <br /> Disliwashcr Gasrange <br /> Clolhes washer Cblhos dryer <br /> Wat�r hoater Range hood <br /> Sink(sorvicdbar/mopletc.) _ Exhausl lan <br /> B�ckllow prevenlcr _ Hoal pump <br /> Urinal Unit healor <br /> Drinking Founlain _ Boiler <br /> Floor drain Relrigoralion <br /> Grease Irap _ Woodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> I hereby ceritily Ihat I have read and ezamined this application and know lhe same lo be Irue anA correct. All provisions ol laws and <br /> ordinaces govoming this rype of work wlll ba complied wilh whother specified herein or nol.The granting of a pertnit does nol presume <br /> to give authority to violate or cancol tho provision ol any olher slale or local law regulaling conslructio�or the performance of <br /> construction.That I am aulhorized by the owner ot lhis prop�rty to pedorm the work lor which application is made and I wmply with Ihe <br /> Stalo Conlractors Law 1 B27 RCW and 29G200 WAC. <br /> Signature of OwnedContractorlAuthonzed gen� �ate <br />