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— — ^ <br /> P�►�RNlIT APPLICATI�N <br /> ITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> �J�p� ,���caclu+a�, 425-257-8810– FAX 425-257-P857 –www.everettwa.org �i, l ��� �/ p <br /> (N � <br /> APPLICATIONS ARE P�CCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS N e X t f u Z 3 0„ PARCEL TAX I.D. i� PERMIT# <br /> 5,2 .,�� Sr s �- Ev�� � � t ._ U�S�o�000t� z �o� �4/�1�i— <br /> LEGA LOTNO. BLOCK TRACT <br /> oEs�. � p Lv (,ve ll i/ � e c,J �"rac KS <br /> OWNER AD�RESS CITY2IP PHONE <br /> 7"I,e Tr� cic.�ay CarF poB 3� � y �Vere-i-} , W�� �1z_s.3a38�oo <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �` f�A�- tiy NZ5363-.y1DD - 3µ s- � aip <br /> CONTRACTOR -J�hQ -Tredwny C6�-� APo� 301 '� �V�✓ecf'{-,2�r�/� y25 3�3-5' 100 <br /> CONTR.LICENSE# Tr-v ���` J S� K.T <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> /�/��J S �= Ye S r ��nC� Eleclric �CGas_Other ��� <br /> WORK DESCRIPTION <br /> .N e :.� S F 2<:-S • ��.c,t� �l 2 <br /> — PLUMBlNG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilet A/C–21r handling units <br /> / Ba!htub J_ Forced air systems <br /> � Lavatory(wash 6asin) J_ 3as piping <br /> I Shower I �Valer heater <br /> I Kitchen si7k&disposal � Gas fireplaca <br /> / Dishwasher Gas range <br /> L_ Clolhes washer J_ Clolhea dryer <br /> Laundry tray _L Range hood <br /> Sink(service/badmop/etc.) � Exhaust fan <br /> % Backilow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other_ <br /> Other <br /> CITY OF[VERETT LOCAL SAlES SAX CODE IS J705 <br /> II hereby centify th�t I have read and ezamined this appliwtion and know the same ro be true and correcL All pmvisions of laws and <br /> I ordinaces governm j th�s type of wcrk�vill be complied with whether specified her=in or not. The granting of a permit does not presume <br /> ito gi:•e authonty ta violate or cancel the provision of any other state or tocal law regulatine� construction or the performance of <br /> consWction.That I am auihorized by the owner of this property to perform the work for which application is made and I comply with the <br /> � State Contractors Law 18.27 RCW and 296.200 WAC. <br /> I Signa ure of neo onlrector/Autho d Agent � Dat� l�� <br />