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` �- ��_ 3-�-- b <br /> �- - --- --- - ----- - — - --- <br /> PERMIT APPLICATION <br /> CITY QF EVERETT PERMIT SERVICFS <br /> 3200 CEDAR STREET, EVERETT, WA 98101 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N P M)T N .. <br /> 4zS E. cds/hfp I2D , � �oS07U0302200 I �L,'�'.� 'C� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC ��' f�'�jJ�CI F]� <br /> OWNER JV/�y� LU�a[yl ADDRESS CITY2IP PMONE <br /> `�,F�'ol �A'rONA �Jt� NL-. S�d+1TLF� W�F, q�14� 1o6•A64•Y9Z6 <br /> P,O, 13dX 455SD <br /> tENANT NAME rCjOON�CT�(�U�M`I/.T� PHONE <br /> Ko�-+��v1 ASS�f, I�CM7Fcn �a�•6�S 9itlU <br /> CONTRACTOR / _ ADDRES9 CITYIZ:P PHONE <br /> �� � l' ' l � � � <br /> CONTR.LICENSEM � / / I���� � �� . 1.�� ��E���� ���C�� ���I ��� <br /> USE OF BUILDIN6 HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��Mn�n2 yA,2n A,�� , <br /> 2E7All S'Td✓�F �C ElecMc �CGas_Other �`���.- ��.) <br /> WORKDESCRIPTION /ZZ<YNQrJ[L E X�Sr/NG /�'I-ST/20dM S� Crn�51�QUGr nlEi.� MAN�►GEn's' <br /> oE"Fic� vnDc�2 �X�ST, Lu7t"12fd12 I�OdF OV�NAlJ6 , App K/TtHM �aun•t�¢ <br /> 7a c=xi�riNc� aFF�cF , coNvcnr 7a ��p�oy� �✓h�+ R47M . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TVPE OF FI%TURE OR ITEM <br /> , � Toilet _ A/C–air handlmg units <br /> Balhtub _ Forced au syslems <br /> �Z Lavalory(wash basin� _ Gas piping <br /> � Showei = Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> ` Dishwasher Gas ran�e <br /> 'Clothes washer Clothes tlryer <br /> Leundry Iray _ Range hood <br /> Sink(servicePoar�mop/etc 1 _ Exhaust lan <br /> Backpnw preventer _ Heat pump <br /> 3 Unnal� _ Und heater <br /> DrinkinA fountain _ Boiler <br /> Floor d�aih Retngeration <br /> Grease Ira{i., _ Woodstove <br /> Roof drams `� Other <br /> Other \ <br /> — ----�— — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cen6fy Ihat I have read and examined th�s applir.ation and know the same to be true aed correct. All provisions of laws and <br /> ordinaces govermng Ihis type of work will be comphed with whether speGfied herein or not The granting ol a pertnR does not presume <br /> Ito give aulhority to violate or c2ncel ihe provision of any olher stato or local law reyulating consiruction or the performance ol <br /> conshuction That I am authonzed by the owner of this property to perfortn Ihe work for whlch applicadon is made and I wmply wAh ihe <br /> I Slate Conlractors Law 18 47 RC'N and 296 200 WAC. <br /> `� 1�I.u..�C' h��r�CG=,�— _s< r �'—o E, <br /> �i nature o wner/ ordracrod ut onz. gent Date <br /> J� <br />