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� _ s —c�� <br /> — — - — - - . _-- <br /> ------- _----- ------ <br /> c � <br /> P�RMIT 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 8 AM TO 4 PM <br /> SITE ADDRESS /� �L PARCEL TAl(I.D.N PERMIT N r � <br /> Z ��/ �a-sil,n k�Y �v�rrA/ ��� �'�J�UW- v <br /> LEGAL cL%^NO. � BLOCK TRAr�n��� � �r�y,�. �S <br /> DESC. �� CC � � <br /> OWNER ADDRESS CITY2IP PHONE <br /> _Zhe, IL �rp. l ;•-"� i f5�-)�l�c1'� LI/oy /U� f7u /44( 11��� C`��y��jj7• �,7�t'�j <br /> TENANT NAME I CONTACT FOR PER IT � PHONE <br /> '� i}-J ti J7U )J �� <br /> _J ,•• <�ln rs..t <br /> CONTRACTOR C ADOR �t- � G,/Tl121P PHONE <br /> � �n'J�L LZ �. �.��'1�" 9 l.�l'.`:.� . 1j����t.���V?� �.5'J�' �'�1 .ri,�.� V��A�� <br /> ��yuR� x <br /> CONTR.LICEN3�U t/ � <br /> USE OF BUILDING / HEAT SOURCE CONTRACT PRICE OF WORK <br /> J`� �1Z' � / — — — " . �0 C <br /> „_., ,. ,�,_ �" Eledric Gas Other ^- � � � -� <br /> WORK DESCRIPTION <br /> (- /, D . .-. ,e-•,.,p. R*c�: <br /> { �-� [ o�, ��,y.. ,fi �it4r_twv 'J' �•r'tiA. J �ln� / <br /> }Ce - t2,o"li�`�{ ; ? /'�j"1' o) �a�+^ � �t J ,. <br /> � � ✓ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%7URE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toile� A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavabry(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Knchen sink 8 disposal _ Gas fveplece <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> ^ Laundry Iray _ Range hood <br /> Smk(service/bar/mopletc.) _ Ezhaust fan <br /> Dackllow preventer _ Heal pump <br /> Urinal Unit heater <br /> Drinkmg Foun�ain _ Boiler <br /> Floor drain Refrigeration <br /> Giease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CIiV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby centity that I have read end exarr�ined this appilcatwn and know the same to be true and corred. All prowsions ol laws end <br /> ordmaces goveming this rype of work�will/be complied wlth whethe�specified herein or not. The graMing of a permit dces not presume <br /> to give authority to violate or cance �he prov�sion oi any other state or local law regulating construction or Ihe perlormance of <br /> conslrucUon That I am authorized�y�e owner ol this property to perlorm Ihe work lor which application is made and I compty with the <br /> State Contractors Law 1827 RC�IV en �9�200 WAC. <br /> ��'"� '�_�_�_ � ��.Z'j/ G <br /> Signatnre o wnedConlradodAut nzed Agent a <br /> I <br /> I <br /> I _ _ _ _ -------- ---- <br />