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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 />AP <br />PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL. TAX I.D. # <br />PERMIT # <br />�-lt ll:� ��+V.s.-��& P(O IR, <br />(:) C (o c5 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. ! <br />� <br />�Y/ <br />0C. �P i ) fC�C���sv� IL(JZ S C-(.> <br />OWNER <br />ADDRESS CITY/ZIP PHONE <br />hkt'.c+�L2. ak� <br />L7o <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />I <br />Ile <br />CONTRACTOR pP-tS2� ADDRESS CITY/ZIP r PHONE <br />CONTR. LICENSE # i l- f�3 he <br />1-"l Q�Gf4 01 zG ' �5bi-D�- LAa.S'-1R.3 1-11 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />—Electric _Gas Other <br />WORK DESCRIPTION <br />�' ��Z S�i/L lx..L-�- l L.'Kvi � "�i,2,� S 6 Y1.� t � �-t-'v'19� . •�iA <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />�)_ <br />Toilet <br />A/C - air handling units <br />.9, <br />Bathtub <br />i <br />Forced air systems <br />LA_ <br />Lavatory (wash basin) <br />1-1 <br />Gas piping <br />_j_ <br />Shower <br />I <br />Water heater <br />I <br />Kitchen sink & disposal <br />1 <br />Gas fireplace <br />i <br />Dishwasher <br />I <br />Gas range <br />Clothes washer <br />I <br />Clothes dryer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />j <br />Ll <br />i <br />Range hood- Iwlrgt,�, <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 authority to violate or cancel the provision of any other state 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 I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />V1 <br />