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__ _ <br />. � - - ____ _ _ _-- - - _ <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, [VERL=lT, WA 98701 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa org <br />SITE ADORESS <br />40� N.cA <br />ie�n� �orNo. <br />orsc _1 � _ <br />OWNER <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I � DI �W3 <br />-- — - -- -- . ^----- — _--- -- — — - — ----- <br />PARCEL TAX I.D. Ii PERMIT # <br />I�OT 2 p_ 00 39_33 000 029 � ---- _�-112� -- <br />--�BLQCK TRAGT ON SUBDIVISION tl <br />--- ---Bc_Y_��y���..��__Di��sl.o�_ No.S ,. <br />ADDRE55 CITV/ZIP PHON[ y25 ,. <br />�iOGE2 AN06���•1 q04 N CAt3cr-r 2�,_EVC�eE�1TWA. �'�3•yy91 <br />TENANTNAME CONTACTFURPERMIT P���NE y25-�43-9441 <br />fl�E2 ANOEQ_.SON E�MAII <br />C iR �9TOR ---� -----��-- AUDRESS <br />---... - --�- — CITYi2iP . ..— PH3N[ ��-- � — <br />CONTR. LICENSE N y ��� N�r � <br />�� 1 <br />. . __'_' _ —'___'_ __ _— —__. __ "__ _ —__ ___' ._—_—'—'— _ _—'_ _ __— _' "_—_—_ __ <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />� p Rq G �� x[lectric _ Gas _ Other �__ <br />-- —� ------�---- ------ <br />WORKDESCRIPTION ��rACHEO GA��:a� �NST2UCTION <br />—... — <br />PLUMBING <br />NO. I TYP[ OF FI%TUR[ OR ITEM <br />iodel - -- ---- — � --._. ._ <br />—�-- �athlub <br />— — I.avalory (wash bas�n) <br />Showcr <br />Kitchen sink 8 disposal <br />Dishv�asher <br />Clothes washer <br />Waler healer <br />Sink (scrvice/badmop/cic ) <br />�ackllovi preventer <br />_..._. Urinal <br />Drinkmg �ountam <br />� Floor Aiain <br />Greasc Irap <br />Rool drains <br />--� Other.__ _.-----. <br />� <br />31XZ8— <br />MECHANICAL <br />NO. TYPF.OF FIXTUR[ OR ITEM <br />�/C — air handling unds <br />Forced au systems <br />_ � Gas piping <br />Waler healer <br />Gas lueplace <br />Gas range <br />Clolhes dryer <br />Rangc hooJ <br />-- 1-rhausllan <br />I leat pump <br />Und healer <br />Hnder <br />f3ehigcration <br />Woodstove <br />�_ ., Olher_ _._ <br />--- � -- — --�--------_._._.----- <br />� CITV OF F.VERETT LOCAL SALES TA% COUE IS J105 <br />I hereby certdy U�al I have read and e■ammed this apPlication and know the same to be true and correct All provisions ol laws and <br />ordmances govemmg th�s �ype o( work wdl be comphed vnth whether specified heiein or no� The g�an6nq of a pennd does not presume <br />to g�ve authonty to violale or cancel Ihe provison of any other slate or local law regulaling cons!rur,hon or Ihe peitormance ol <br />conslruction 1 hal I am authonzeA by Ihe owner of Ihis property lo perloim Ihe work lor wh�d� appl�cahun is made and I comply with the <br />Sta!e Contradors Law 18.27 RGW and 29fi100 WAC <br />, ��� ��_/��% <br />natwe o wnedContr ctor/Au nzed ngen� Daie � I 2 <br />