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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.evere�'wa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. N <br />PERMIT N <br />Sao N.c/Jr„„o <br />oo c7cvQ'Sgoo <br />1'�L�IU� <br />LEGAI LOT NO. BLOCK <br />TRACTOR SUBDIVISION N <br />DEsc. 3 C'OIO o0 <br />/�Ev.�,: 1..-Y �T.PY 7'irAcT,T �; • .Z <br />OWNER ADDRESS CITY2IP PHONE <br />GLEN UNA �.Z'orER7�Fd 370 / FvFC or%✓� CT. ZYT. /OV.r7-N, <br />it <br />.r v. /io _ Tyr 7 v7 x/ <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />7)AV:p JvvR A7tN <br />I <br />CONTR. LICENSE N <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORN <br />Electric Gas OIhCr �� <br />l Cl <br />WORK DESCRIPTION <br />i NrTil4-✓i-�"7U•-r O.= /1�L�w r��_ ci_- l"U rl �i ..es'.r /4'Fi�-nv< L <br />T <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C -air handling units <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Harge hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust tan <br />_ <br />Backllow preventor <br />_ <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boller <br />_ <br />floor drain <br />Relrigemlion <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />CJlhor <br />_ <br />Other-- - <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerltily that I have road and examined This application and know the same to be True and correct All provisions of laws and <br />ordinates governing This type of work will be complied with whether specified herein 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 or the performance of <br />construction That I am authorized by the owner of this property to perform the work for which application is made and 1 comply with the <br />Slate Co ctors Lew 18.27 RCW and 296.200 WAC. <br />s <br />ignalure of nedConiractor/ ut o ze gent De <br />