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. � <br /> PERMIT APPLICATIOM I�U� �l°9 � ��� � <br /> CITY OF EVERETT PERMIT SERVlCES �F� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> �/� � — � 425-257-8810—FAX 425-257-8857—www.everettwa.org �`j��"?� ��f-(���, <br /> �U'� 5 ,�,T��c�L�.�l.ty <br /> APPLICATIONS AR�ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS�I� lP���O� l"jy+G�- PARCEL TAX I.D.# PF.�2MIT# <br /> 0045823�5oot3oo 1��, _ � <br /> �� oA V�. <br /> LEGAL LOTNO. BLOCK TRACT <br /> oEs° lo- 1 to 33� <br /> OWNER ADDRESS CITY2IP PHONE <br /> C�� 1�a5�-1 ��1"��i'�lSLS 3977 �sAgY 1�1AY ►�I►�• �6I 7� � ��/L <br /> TENANT NAME � Y' -t-v CONTACT FOR PERMIT PHONE <br /> ��t�las6. I.�tJ� o+Jct i'e;�nits bq�tlt� t7�/�� ��1 �0�.►-1 ���� qZ5•£�zl•?7(00 <br /> npc. Ava1�A <br /> coHrrucroR-�-p�,{7��� � �/: �-'���>;noo ess cirrrzir rHpHe <br /> � � �;�j G;GCa -77,�L� - ��c��i� <br /> CONTR.LICENSE• , .i. � : � <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ����'�`—��U����(�. �Electric _Gas_Olher ��,�j(� ('Q(�o J <br /> WORKDESCRIPTION 5,qsfo '� �vW�l.,�1,�b� 4p��M�r �/ (p {�V�t7 ��j�,q��c) � � <br /> �tlo4 � WAI-K-��1 7AY kloSK. kloSK �to 5�-�- }��- p�cK�,� <br /> N�.1 ba���.r �-t+er�s -r-cp�c.au..�� sa�p �- �u� st,.�-�a.l k�ds�s. <br /> PLUMBING MECHANICAL <br /> N0, NPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> �_ Toilet � A/C—airhandlingunits <br /> Bathtub \ Forced air systems <br /> � Lavatory(wash basin) S Gas piping <br /> ,� Shower ,� ` Water heater <br /> �' .Kitchen sink 8 disposal _ �s fireplace , <br /> _ �shwasher Gas�range <br /> Clothes washer ClothQs dryer <br /> Laundry,tray _ Range�p od <br /> � Sink(seNic�eR�ar/mopletc.) � Exhaust fa� <br /> Z BackAow prev�ter Heat pump <br /> Urinal Unit heater <br /> Drinking Fountai\ Boiler <br /> � Floord2in \ _ Refrigeretion <br /> Grease trap Woodstove <br /> � Roof drains ,� Olhe�I�bN� I�l��c� <br /> Other <br /> \ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or noL The granting o(a pemiit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construdion or the performance of <br /> construction.That I am authorized by the owner of this property to perTonn the work for which appliwtion is made and I comply with the <br /> State Contracto nd 296.20D WAC. <br /> �� �i •?_�� <br /> S re OwneU ontrac dAuthonze Agent Dat �i <br /> �� <br />