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:3 <br />5 <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 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />ao '--7GOr q Z <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNE <br />ADDRESS CITY/ZIP PHONE <br />v-'�o C-rz it l (c�3 ` 2 � i.�� S�t��n��� �IR2 3(d-5�6g-�� <br />r cl� � <br />TENANT NAME <br />TACT FOR PERM T PHONE <br />Ark "�Q�,.�Yg-s-3 3IaA <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />&Y 1150 S;7iklwvt WA q9?-'90 7G4-664-133t& <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />ElectricljQ Gas , Other <br />� / 37 <br />[yv <br />WORK DESCRIPTION — <br />y IJ� <br />PLUMBING <br />— M.EGW <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet / % r <br />A/C — air handling units <br />/ // <br />Forced air systems <br />fBathtub <br />Lavatory (wash basin) J� 1Gas <br />� <br />piping <br />Shower <br />/ 0 <br />Water heater <br />I_ <br />Kitchen sink &disposal <br />Gas fireplace g� <br />l <br />Dishwasher <br />Gas range <br />Clothes washer <br />—7— <br />Clothes dryer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Range hood <br />Exhaust fan , <br />Backflow preventer <br />Jr <br />Heat pump <br />V <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces 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 a—uthbrity to violate or cancel the p r on of any other state or local law regulating construction or the performance of <br />constr ti . Th a t`� o ' e owner of this property to perform the work for which application is made and I comply with the <br />State acto Law .2 C and 296.200 WAC. <br />Sign re of Owner/Contrac u orized Agent Date <br />1.1 7 <br />