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PcR�MIT APPLICATI�N ` <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-9810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM S - a(,F�p'� <br /> SITt AD SS ^ / v�oSO � IpLUI� PARCEL TA%I.D.N y���T���� <br /> ��l, T� Oo�o 9 0000c� 8� U <br /> LEG LOTNO. BLOCK TRACTn ' J� � r ' • <br /> DESC. � ��T�� ��- T1sC aC� �'� <br /> OWNE AODRE68 � P H <br /> �o�. ` �rs.� ,J � 1� y o-�' P� yzs- z-� � —sz59 <br /> TENANT NAME CONTACT FOR PERMR PH� <br /> 7•��-e I �o�-� 0'ti- �� �Z�-Z3)—�'i29�i' <br /> CONTRACTOR ADDRESS CITY2IP ►NONE <br /> CONTR.LICENSE 11 <br /> USE OF BUILDIN6 I — HEAT SOURCE I �ONTRACT PRICE OF WORK <br /> Electric _Gas_Other '� � O O C� <br /> WORK DEBCRIPTION 1 <br /> ,yaw�u c�� K�-Ksx a „�d L'�7�+�-S . 0.tSo '�-R-Q�-S <br /> ��o.� £aS�-� �.l A J� - <br /> PLUMBIN(3 MECHANICAL <br /> NO. TYPE OF FI%7URE OR ITEM ND• TW8 OF FIXNIIE OR��M <br /> Tollet A/C-alr haMling units <br /> Bethtub _ Forced elr eyetema <br /> _ Lavalory(wash basln) _ Gea plpinp <br /> Shower _ Water heater <br /> Kltchen sink&disposal _ Gas Oreplaco <br /> �Ishwasher _ Gas range <br /> Clothes washer _ Clothee dryer <br /> Water heater _, Range hood <br /> Sink(servlce/bar/mopletc.) _ E�auntlan <br /> Backflow preventer _ Heat pump <br /> Urinel _ Unit heater <br /> Drinking Founlaln _ Boiler <br /> Floor draln _ Refriperatbn <br /> Grease trap _ Woodetove <br /> Roof drains _ Other <br /> Olher <br /> CITV OF EVERETT LOCAL SALEB TAX CODE IS N05 <br /> I hereby cerillfy lhat I have read and examined this appllcalion end know lhe same to be true and corted. All proWabna of laws end <br /> ordinaces goveming this type of work will be complied wilh whelher apecifled heroin or not.The pranUng of a pertnit does not preaume <br /> to give aulhority to violale or canc lhe provision of any other alale or local law repulaUng construcUon or the perlom�ance of <br /> wnstructlon.Thal I am the owner of this properly lo perform the work for whlch epplicetlon ia mede and I comply wifh fhe <br /> State Conlraclors Law . e d 298.200 WAC. <br /> 'S- 2�} I U� <br /> Signelure o Owner ontraclor ut odzed/Tgent ale <br />