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u <br />PERMIT �►PPLICATION <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Q��- y--D � <br />SITEADDRESS H��19 ���;�,�:�Z�,Y BI.VD <br />DESC <br />LOTNO. � BLOCK <br />m.utaui�c;,t coysrtiurnoN <br />TENANTNAME <br />CONTRACTOR <br />RCONTR LICENSE�N�"'y�� I^( <br />RO-131-NP-`272C' <br />USE OF BUILDING <br />tiINGLI� fA�11�.y RI=tiIDENCI: <br />PARCEL 1'AX I.D. # <br />YI:L[�ll <br />PERMIT <br />CITY2IP PHONE <br />I CONTACT FOR PERMIT PHONE <br />� KP.NROI3INSON-Ii1.A1SI.IG (360)303-7a62 <br />ADDRESS CITYIZIP PHONE <br />,9i30 IZa"III AVG N.li :V2LIKGI'ON �82'_3 (3ti0)a03-7dG? <br />HEATSOURCE <br />_ E;ectric _ Gas __ Olher <br />WORK DESCRIPTION <br />INS'I':\I.I. PIRIi SPRINKI.GR Sl'STI'.�1 IN NIi�1' SPIi <br />NO. <br />TYPE OF FIXTURE OR ITFM <br />Toilet <br />Bathtub <br />Lavatory (wash basn) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service�badmop/etcJ <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Rool drams <br />OIhO� <br />CONTRACT PRICE OF WORK <br />S?S�l� <br />NO. I TYPE OF FIXTURE OR ITEIN <br />A/C — air handling unrts <br />Forced air systems <br />Gas piping <br />Wa�er heater <br />Gas fireplace <br />Gas range <br />Clathes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boder <br />Re�ngera6on <br />Wocdslcve <br />U;nEit C:�I.h I< i II �.,\U, <br />CITY OF EVERETT LOCAL SALES T4% CODE IS J105 <br />- I hereby ceritify that I have read and exammed this applicaLon and know the same to be true and correct. All provisions o( laws and <br />�� ordinaces 9overning this type of work will be comphed with whether specifed herein or not. The granting uf a permit does not presume <br />� lo grve authonty to violate or cancel ihe prowsion of any other state or local law regulating construction or the per(ormance of <br />I const:uchon That I am authonzed by the owner of ihis property lo peAorm the work for which appliwlion is made and I comply wi�h the <br />I State Contractors Law 18 27 RCW and 296 200 WAC <br />�I 1 � \' . �. /� 1% ///.. /�l <br />