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� � <br /> PERMIT APPLICATION y-O6 -a � <br /> CITY OF EVERETT PERMIT SERVICES �I„� �o�, -� g <br /> '� 'I 3200 CEDAR STaEET, EVERETT, WA 98201 <br /> � � 425-257-8810- FAX 415-257-8857- www.everettwa orq � � - � <br /> .:�t /'�� ' � � '� � - <br /> yi ,// APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT p <br /> �y����>TEr7'�ov�r vaRr� �1�'o`{o�cl��3�>�:U _��� ���' ' ��`��' ) <br /> L[GAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> Il[SC. � '-( <br /> OWNER ADD ESS CIIY/ZIP PHONE <br /> �n-t-tna� Oe.ve�oPr-teuT «4cn swt�ce�.rreR <br /> CvMPAN�( '�KWAY� $uiCC 602 SRattLE.�9`dl� 2�-24�oS5u <br /> TENANT NAME CONTACT FOR PERMIT PMONE <br /> _-_ Jol++� LLA4�aA �{25-�4�- 1a� £'� <br /> �,Ma1L• JoNN. �LpcvNAQSY�JTH CC.UH <br /> CONTAACTOH P41.�'�'�b�ll AODRESS CITY2IP PtiONE <br /> Co�j RJGTto/.l ING }(�(y�{a� �iGE�,7�f�R �jEAtrtl.r;� 2�-838•38`�� <br /> CONTR.UI:ENS[MpA NaTG�9aN� l'KWY�SV ITG �2 �gj��� <br /> � f� <br /> USE OF BUILaING NEAT SOURCE CONTRACT PRICE OF WORK <br /> `7T�1�!�/C'���G� _ElecVic .YjGas--- Other I� ������ ` � � <br /> WORK DESCflIPTION �E4.( �L,��L�p SF �'��-'r �1�1G(ZE�I� <br /> �F�l��`C�IAd.. tbv\�T711�1C.n �j' � <br /> I <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NU. TYPE OF FIXTURE OR ITEM <br /> Toilet __ A'C-air handling units <br /> Balhtub _ _ Foiced air systoms <br /> .... . Lava�ory(wash basin� ---- Gas piping <br /> � Shower Waler heater <br /> Kitchen sink 8 disposal ___ Gas lireplaco <br /> - Dishwashei Gas range <br /> Clolhes washer _ Clothes dryer <br /> Walor heater _ Range hood <br /> Sink�servico'bar mop�etc ) __ Exhaust lan <br /> Backllow preventer _____ Heat pump <br /> Unnal __ Unil hoaler <br /> . Diinking Fountain „_ Boiler <br /> Floor drain _ Felrigeration <br /> Grease Irap __ Woodstovo <br /> 2°j__ Roof drains���J�ERS Other <br /> , -- ---- ----�-- <br /> Olher— -� � --�--- ---- - -�------�- <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritify Ihat�have road and oaammed f.��s appllcauon and know Uie same to be irue and r,arec�. All provisions of laws and <br /> Iordinaces yoveming�his typo ol work will bo complied with whether spe:ilied herein o�noL The granting of a permit does noi presume <br /> I to grve authonry lo v�olate or cancel Ihe prov�sion ol any other slate or local law reguiafing construction or the pedormance ol <br /> construction. That I am aulhorized by ihe owner ol Ihis property to pertorm Ihe work lor which applica�ion is made and I comply with ihe <br /> i Siato Contractors Law 1 . RCW and 296.200 WAC. <br /> I � ��� 5����1 <br /> IS n. ine ol Qwn ; onVactor� uthorizetl_ gent ate <br /> __..___. �'�� <br />