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c <br /> PERMIT APPLICATION <br /> CITY OF E��RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-9810-FAX 425-257-8857-www.everettwa.org I <br /> APPLICAT�7N3 ARE ACCEPTED FROM 8 AM TO 4 PMI <br /> SITE ADDRESS PARCEL TAX t.D.# I P RMIT# <br /> D/;1� a o 7 � • - <br /> LEGAL LOT NO. BIOCK TRACT <br /> DESC. <br /> OWNE ADDRESS CITV/LP PHONE <br /> TENANT NAME CON7ACT FOR P'.RMIT AHONE <br /> �ENSLO h' -F� C�I IbD6fJ 4'Zr• �3 � '��`('� <br /> CONTRACTOR ADDRESS � N.TY21V PHONE <br /> I �jELLEVJ'E MEtkiANlc�l. Ic�'QfI �3� A�YE. NE �LG�/VE� L�Jl4 . �IS <br /> CONTR.LICENSE t <br /> g�-� �a�� �/z�/�l 4zs - 4s� -z�e <br /> USE OF BUILDING HEAT SO CE � CONTRACT PRICE OF WORK <br /> I � r <br /> �'(A�IL WA(� pV _Electn: �Gas_Other ,�aZ�O �0�� <br /> WORKDESCRIPTION I�;TGL� `ZJ ��F r�P ��I �L��- A'G VN1"D3 — <br /> I +-3'fM..L (2) 'g�tT<YfZov.•n ��HfAV ST � . <br /> ��'�x�n .4u G Ce.-rTao c.3 4� ��bs <br /> PLUMBING MECHANICAL <br /> NO. TYPE uF FIXTURE OR ITEM N0. � TVPE OF FIXTURE OR ITEIF <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) \ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> Sink{service/bar/mop/etc.; �� E::haust fan <br /> I = Backflow preventer = Heat pump <br /> Urinal Unit heater � <br /> Drinking Fountain Boiler <br /> rloordrein � Refrigeration <br /> Grease trap lNoodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERET�LOCAL SALES TAX CODE IS 1105 <br /> I hereby:eriti(y that I have read and examined this application and know the same to be true and correcl. All provisions of laws and <br /> . ordinaces governing this type of work will be wmplied with whether specifietl herein or not.The granting of a permit dces nol p2sume <br /> to give authonty to violate r cancel the provision of any other;iate or local law regul3ting�nstruction or the peAormence of <br /> construction.TA�f liam a thorize t owner of this property to perform the work for which application is matle and I eompty with the <br />� State Contr�cto Law 1 27 W d 296200 WAC. <br /> � l/ /o of <br /> Signature Owner/Contractn uthorized Agent ate <br />