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PERMIT p►PPLICATION <br />CITY OF EVERETT PERMIT SERVICES �`� �_. J,6 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.orc� „ � -; -• `� (, � �� —� j <br />r �t � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITcF. ADDRES <br />J� <br />�ecn� �or <br />DESC. <br />����'��1 ���j L1-ill <br />io_ —T- e o <br />5Gn `��(�1�,5 �nc lD1'21 f�� <br />PARCEL TAX I.D. p <br />� �? 'C,�%�Y.Y�706 - <br />���K 6ra��� � <br />d <br />PERMIT A <br />Li .. �I <br />TENANTNAME CONTACTFORPERMIT PHONE <br />�ar ry R�z:,na.r Zv[o -�('18- (n�l u � <br />CO TR CTOR ADDRESS CITYIZIP PHONE <br />�-t�;san �VoMe�.�n�. �AM� a5 uwne,� u2s�-�135-[vac�R <br />CONTR. LI(:ENSE p I��`(=SN Y Ci.'� "J�C..3 <br />USE OF BUILDING <br />WORK <br />PLUWIBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />To�let <br />Bathtub <br />Lavatory (wash basin) <br />Shnwer <br />Kltchen sink 8 d�spcsal <br />Dishx�asher <br />Clotnes washer <br />Laundry tray <br />Sink (servicelbadmop'etc ) <br />Back(low preventer <br />Urinal <br />Drinking Founta�n <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electric � Gas _ Jther <br />CONTRACT PRICE OF WORK <br />3f,��� l�i� <br />a3�� <br />TYPE OF FI%TURE OR ITEM <br />NC — air handhng unds <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas f�replace <br />Ga� range <br />Clothes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unit heater <br />9oiler <br />Relrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SAIES TAX COOE IS �105 <br />I hereby cenhfy tnal I have read and examined this application and know lhe same to be tme and wrrect All provisions of laws and <br />ordinaces goveming Ih�s rype of work wdl be comphed with whelher specdied herein or not. The granting of a permd dces not presume <br />�o grve authonty to violate or cancel the provision of any other state o� local law regutatin� construction or lhe perlormance o( <br />construclion That I am authorized by Ihe owner of ihis property to perlorm the work (or which applica:ion is made and I comply with lhe <br />State Cun�ra tors Law 1827 RC}N and 2�6.7�00 WAC. <br />%� � .,� � ,� � / � ���, <br />L_-';%'lU %i ;'�l-C��l�+ _ <br />