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� P�RMIT APPLICATION � <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 32G0 CEDAR STREET, EVERETT, WA 98201 <br /> j 425-257-�9810- FAX 427-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> m os d�-��J3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRES5 CITY2IP PNONE L� <br /> 2 � c cRE�',vF� � �i c,� i�.� �cE✓ c vE�u�sr a,�. �b'za�t � �P r��8 <br /> TENANT NAME —� I CONTA T FOR PERM�T � ' PHONE <br /> CONTRACTOR SM�%3/ �c.�JT7tV�'�N AODRESS M :ITY21P PHONE �.�z� <br /> / uq2 7- zi - ��,v, rf. ��1�P � 3 7c J�y <br /> I CONTR.LICENSE N — — <br /> r - i�SM � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRI�E OF WORK <br /> [leclric Gas Olher <br /> WORK DESCRIPTION <br /> � <br /> _ I< <i '<Acc,_� ��.9J1"i. /1<>> !2 - — <br /> PLUMBING MECHANICAL <br /> NU. TVPE OF FI%TURE OR ITEM NO. TYFE OF fl%TURE OR IiEM <br /> Toilel A/C—air handling unils <br /> Balhlub Forced air syslems <br /> Lavalory(wash basin) Gas piping <br /> Shower L Waler healer <br /> Kitchen sink 8 disposal Gas(ireplace <br /> Dishwashor Gasrango <br /> Clothes washer Clothes dryer <br /> L�undry tray Rango hood <br /> Sink(sorvicelbarlmop/ctc.) Exhausl lan <br /> BackOow pro�nnler Hoal pump <br /> Urinal Unit healer <br /> Drinkina Founlain �oller <br /> Floor drain Re(rigoralion <br /> Grcaso trap Woodstove <br /> Roof drains Olher <br /> Olhcr <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby ceritify that I �.�.ave road and ezamined this application and know the same to bo lrue and carrect. All provisions of laws and <br /> ordinaces governing this ty�e of work will bo complied wilh whetlior specified herein or r N.The granting ol a permit doos nol presume <br /> lo givo authoriry to violate or cancel the provision of any other stalo or Io�;ai law regulating construclion or the p�dormance of <br /> construclion.That I am author ed,by ihu owner of this propeity to peAorm Iho work lor which applicztion Is made and I comply wilh lhe <br /> Sla j� (t\ctora La`,�� 8.2 i �d 29G.200 WAC. <br /> � ��� 9 J l{ /�C.'/�p � <br /> i naWro o f ned C tfactod Ihonzed A ent Dato <br />