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._ —_...-- ------------ ----- <br /> PERMlT �PPLICAYI�N <br /> � CITY AF EVEREI'T PERMiT SERVICCS � <br /> � , <br /> 3200 CFDAR STREEI", EVERETT, WA 98201 <br /> 425-257-t3810 - FAX 425•257-8857 -www.everettwa.org I <br /> I APPLICATIONS ARF ACGEPTED FROM 8 AM T1�4 RM � <br /> — - � <br /> SITE ADDRESS , PARCEL TAX I.D.# P RMIT IO <br /> 3`i Zl� (�co ,ac.�,,, ��.�e.�oto � 0 4i?39zs" �mo � I � �'o� - (s� i <br /> ILEGlL LOT NO. BL—� O�K /jRACT n_ r- /1 1, ,�f <br /> � oFsc i �(2.y 1"�c, of��cw� V�Via.b.,,G /u� 'id�r,�+�'S I <br /> OWNER AODRESS CIlY2iP PHONE�� I <br /> a��.�,�� v���s��. L bb C�� Sf 1 �,�c�. ��i 9�r �yr�;�,-� t <br /> TENANT NAME ��� CONTACT OR PERM�T PVIONE � <br /> �GvM�� V'\ I ��5��-� � L� W ( � � � 0 r'U � <br /> CONTRACTOR ADDRESS CITY2IP PHONE I <br /> � r � /, i <br /> CONTR.:.ICI:NSEN 7-� �].P,��C�� .�� JI\�(iy�� ( � � .L��./ , <br /> US�OF BUILDING � — HE A't SqJRCE � CO�RICE OF WORK <br /> � ,•���'(�y Elearic ,__Gas__Other �(, � <br /> WURI(DESCRIP710N <br /> �-� �� i <br /> PLUh1BING MECHANICAL ! <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM � <br /> Toiiel A/C—air handling unds , <br /> Balhtub Forced air systems ! <br /> Lavatory(wash basin) Gas piping i <br /> ShoNer Waler healer � <br /> _ Kitc.tien sink 8 disposal _ Gas fireplace <br /> _ Dishvrasher Gas�ange i <br /> Clothes washer Cblhes dryer <br /> _ Laundry tr2y _ Renge hood i <br /> Sink(sorvice/bar/rtwplelc.) Exhaust fan <br /> _ Backllowproventer Heatpump I <br /> _ Unnal Unit heater � <br /> Dn�king Fountain Boiler <br /> _ Floor drain J Refrigeration � <br /> _ Grease liap V�bodstove � <br /> Roof drains Other ; <br /> _ Other _ — I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 � <br /> I hereby ceritify that I have read and examined Ihis application and know the same to be true and corted. All provisions of iaws and <br /> ordinacas goveming this type of hrorie will be camplied witb whether specified herein or not.The granting of a perrnit does not presume � <br /> to give authority to violate or cancel the provision of eny olher state or local law regulating construction or the performance of I <br /> construction.That I em autho ' ed by tho owner of this property to perform the wori�for wfiich appticatian is made and I comply with the <br /> State Conlractors L��7 W and 298200 WAC. � � �b �� <br /> Sgna ure ef OhmedContrectortAuthonzed Agent�� �( L I <br />