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. <br /> P'�RMIT APPLICATI(.,�V <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 -www.e��erettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I,D.# � �T g <br /> �' ' r� C� W c �O (� —� <br /> LEGA LOTNO. @LOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> CNUN�, ����-- I�i6 3 �fS� �I A--� �.��� Cuc� (,�k <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> c�i�sA�31 rz-��'�� I I ;�I�;i, _P S'� ��G �� . 3 �� � <br /> CONTRACTOR � �'o�1ST��GT� a� ADDRESS <br /> M S I6� 6 3 4-�s� f�f A-�` c�rziP L n PHONE�p 3S G ' <br /> CONTR.LICENSE#OM SLd "�h-� II �Z I�.JC� c� `�- ' a ° �' <br /> �(�003 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �P�a`til-t�w�� I _Electric �Gas_Other y� ��� , vo <br /> WORK DESCRIPTION �� <br /> �hS�-c�ll ��-� ��wk.�'a� �zX-}��cS -�ol- 7.fs c�.ti {-G�- <br /> PLUM8ING MECHANICAL <br /> NO. TYpE OF FIXTURE OR 17EM NO. TYpE OF FIXTURE OR ITEM <br /> _ Toilei A/C–air handling units I <br /> _ Balhtub Forced air systems <br /> _ Lav;'ory(wash basin) 5 Gas piping <br /> _ Shower _� Water heater <br /> _ Kitchen sink& dispos2l Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Ctothes dryer <br /> Laundry tray Range!�ood <br /> �-�- Sink(service/badmop/etc.) Exhausl fan <br /> / Backflow preventer Heat pump <br /> __ Urinal Unit heater <br /> _ Drinking Fountain goiler <br /> Floor drain Refrigeration <br /> � Grease trap Woodstove <br /> Roof drains Olher <br /> �_ Other ��oci' C',...� _ — <br /> _ I <br /> i CITY OF EVERETT LOCAL SALES THX CO�E IS 3105 <br /> II 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 /> orCinaces governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume <br /> ic give authonty to violate or cancel the provision o(any other state or local law regulating construction or the perFormance of <br /> construclion. That I am authorized by the owner of this property to perform the work for which application is made 2nd I cemply with the I <br /> IState tract rs Law 18 7 RCW and 96.2G0 WAC. <br /> t �- ��- - 2� _ U � <br /> IS�na[ure ot VwnenC,ontractor/Authonzed Agent Cate � <br /> I <br />