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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 8 AM TO 4 PM 3 ` ) ) , <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT A <br /> \3 - Cc\b3 AVM- CO Li3cb5ay( coO O t31 " -OIL <br /> LE LOT NO. T BLOCK TRACT OR SUBDIVISION I D `i \� <br /> DESC \ -z,2 J 2`t(o-2 11 \J nr <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> p.)„,�,,i�. W-PLON .e ..sys \�2 \ �1 foil 11- - GJ& -,via- Uzs—zs2 -1414 <br /> i TENANT.NAME `` /' CONTACT FOR PERMIT I, ,, PHONE <br /> i,'LS3_7 \C1 -10,,,-�1���p(�r <br /> �c-Us W re,. V J Lil�� O Q..� 1 Lk- \f C. mcr E MAIL(.7�r�(k't�e° .�R"'"'� <br /> CONTRICTC % -- A'aD ESS CifW/3TP PHONE <br /> CONTR LICENSE r _ <br /> IUSE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I l t Electric Gas_Other - Z Q ooD <br /> WORK DESCRIPTION ..-Eel <br /> 51a\ 1,:- - 0.1V MAj -- \ t„�t4,t-pAl rv1 or <br /> e4...st," peA r • -.�_.�\ 0,'ft'- ' 64- 5..,i�.cxr`�- e.46ipr^t.�� �t�u^ <br /> J <br /> 'eX t t-n 'o P e"X1v".>f '-I\ a )L3 t 1 letA.r$C arc.-- <br /> PLUMBING MECHANICAL <br /> NO. TY^E OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> r Toilet _ A/C-air handling units <br /> I — Bathtub Forced air systems <br /> Lavatory(wash bas.n) Gas piping <br /> Shower Water heater— <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher — Gas range <br /> Clothes washer _ Clothes dryer <br /> Water heater — <br /> Range hood <br /> Sink(service/bar/mop/etc) __. Exhaust fan <br /> — <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain — Refrigeration <br /> — <br /> Grease trap _ Woodstovc <br /> Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310S <br /> I hereby certify that I have road and examined this application and know the same to be true and correct All provisions of laws and <br /> ordinances governing Ihrs type of work will he complied with whether specified heroin or not The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other slate or local law regulating construction of the performance of <br /> construction That I am authorized by the owner of this property 10 perform the work for which application is made and I comply with the <br /> State Contractors Law 18 27 nd298 21\-00 WAC <br /> (`',I1 <br /> • Si ure e,IContractor/Authorized A- gent 2 1` Date U <br /> Ile <br />