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a <br /> 1 r <br /> 1 <br /> 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 a AM TO 4 PM h/OQ/10 <br /> SITE ADDRESS 2903 W Casino Rd I PARCEL TAX I.D.0 PERMIT N <br /> x", x' 1W er �- `0\0 " 00 <br /> ) <br /> LEGAL LOT NO. 1 BLOCK l TRACT OR SUBCKriSIOW <br /> LESC. CfTYJ71P PHONE <br /> OWNEN ADDRESS <br /> F'rort};er Common44,1-r'065 3 Ntyh Qtd Pwk 56"rord1Cr o6i0S $12-41)-141•7 <br /> TENANT NAME r�CONTLACT FOR PERMIT PHONE 51 a-(p I$ - I b b 7 <br /> oMM��►Ga�-�on$ �MG 1 --Cn{' E4ANLMAW0nieGtiAiroiw. OCrM� <br /> Frordiec G � ,cott <br /> COf(iRACTOR ft r po .ESS {3rt„� GI�Ftoe f� t NV PHONE SIB- 61E-1647 <br /> CONTR.LICENSE a t C ((V' I Oe L n <br /> USE Of BUILDING HEAT SOURCE CONTRACT PRICE OF WORKto M rA U n1 CA 1L i o ___Electric Gas Other 4050 C $4 , G 0 0 <br /> WORK DESCRIPTION l� �^ <br /> • <br /> (�et"tAve.,. I�er(Z4 i\ S ;&A0.s.e Gild i f1S),411 t'r0/1her- S ' S✓l. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet — NC-air handling units <br /> Bathtub ____ Forced air Systems <br /> —_ Lavatory(wash basin) — Gas piping <br /> Shower — Water heater <br /> —_ Kitchen sink S disposal — Gas fireplace <br /> Dishwasher — Gas range <br /> Clothes washer Clothes dryer <br /> _ Water heater — Range hood <br /> Sink(senrice/barlmopletc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> — <br /> Urinal _ Unit heater <br /> Drinking Fountain — Boiler <br /> Floor drain Refrigeration <br /> — Grease trap — Woodabve <br /> Roof drains — Other <br /> Other -- <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws end <br /> ordinances governing this type of work Wil be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel the provision of any other state or local law regulating oonstrudlon 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 I comply with the <br /> State Contractors L.w 18.27 RCW and 296.200 WAC. <br /> ignature of •wnerl ontractorlA r ant ate 1I <br />