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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425•257-8810 - FAY l25-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�l a�� <br />LEGAL LOTNO. BLOCK <br />oesc. ��,1415 l(o S l <br />OWNER <br />�t-�aM 4720 <br />TENANTNAME <br />Mo�.f�`tTl�c� �No. <br />L`bAY <br />'.�►4Gaa. Go�571�i.w'itor.� <br />CONTR. LICENSE # <br />'�e,lte►cGr>oVro��' �' <br />USE OF BUILDING <br />�Tf►�L us� <br />WORK DESCRIPTION � <br />�ol.t'('�o►� oF tx4sj'tr� � S�uc�uwEs W1�wI� ToT'nL 3�192 S• • <br />PARCEL TAX I.D. tt <br />TRACT OR SUBDIVISION k <br />ADDRESS <br />�KT O6Wi WA� 130 <br />ICONTACT FOR PENMIT <br />,.ke sT'�7 <br />2I II � . �/�+ue <br />�G� 0 � <br />HEATSOURCE <br />_ Eleclric _ Gas _ <br />l • / � <br />PERMI7 # <br />1 �C7lZ-CG'' <br />�,�.a�WA• 5o9•53S•3� <br />49Zo2 <br />Olher <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF PIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposai <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas lireplace <br />Gasrange <br />Clothes dryer <br />Ra�ge hood <br />Exhaustlan <br />Heat pump <br />Unil healer <br />Boiler <br />Aelrigcration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritity that 1 have read and examined Ihis application and know Ihe same to be true and correcl. All provisions ol laws and <br />ordinaces governing Ihis type ol work will be complied with whether specified herein or not. The granting oi a permit does not presume <br />to give authority lo violale or cancel the provision ol any other stale or local law regulating conslruction or the perlormance of <br />conslruction. That I am aulhorized by the owner of this property lo perlorm the work lor which application is made and I comply wi;h the <br />State Contraclors Law 1�.27 RCW and 296.200 WAC. <br />