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PE�<MIT APPLICATIO�v <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> . 3200 CEDAR STREET, EVERETT, WA�8201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARC ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT p �� <br /> ��lni5 Wi-s"T l�SiN�� �F� 2�•- Q14 -007� !(000 � �`'v� '�� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. �� $f1fL TI•v <br /> OWNER ADDRESS CIIYIZIP PHONE <br /> +�M��1I�f���t� C�tPrM, �^��Mi 13^I S''��,'E � i�uo ;E.riz�i� . �,�h ��l� ( u�E� ) 3€z_�5�s <br /> TENANT NAME . I CONTACT FOR PERMIT PHONE <br /> SIcMA �'t��:c> S�r9F,�=�'�ct� I <�tir�y ,L-Ar�'fr, (`l��� � 7�-107��� <br /> CONTRACTOR ADDRESS C�r11ZIP PHONE <br /> CONTR.LICENSE p <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PR�CE OF WO[tK <br /> �� f �S � Electdc �Ges_Other W /3S,aa'•�° <br /> WORKDESCRIPTION �»�N�''� i 7,� �` Z (�j�7-jyS , r- <br /> Tl�n.:!�n,T ir�cc�v�«rrtir_ ��nrcc , r-un� , nie�✓ N 1� I � ��-cx�s. <br /> T>c-!Cs <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toile� A/C–alr handling unils <br /> Balhtub Forced air systems <br /> � Lavalory(wash basin) _ Gas piping <br /> Shower Water healer <br /> Kitchon sink 8 disposal Gas fireplace <br /> Dishwasher _ Gas range <br /> Cbthes washer Clothns dryer <br /> Laundry tray Range hood <br /> Sink(servico/badmop�etc.) Exhausl lan <br /> Dackllow provenler Heal pump <br /> U:inal Unit healer <br /> i Drinking Fountain �oiler <br /> � _ Floor drain Reingeration <br /> � Grease trap Woodstove <br /> ; Roof drains Olher <br /> Olher <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> II hereGy ceriti y Ihat I havo read and ezamined lhis application and know ihe same to be true and correct. All provisions o(laws and <br /> ordinaces go�eminq Uiis type of work will bo complied wilh whether specilied herein or not.The granting ot a permit does not presume <br /> to givo authonty to violate or cancol the provision of ary other stal�or local law regulating construction or the peAormance of <br /> construction. That I am aut onzed by Uie owner of this property to pedorm the work for which application Is eiade and 1 comply�Nilh the <br /> State Conlraclors L 18. 7 CW and 296.200 WAC. <br /> r,f ' � �r7 � � � 0 <br /> Signalure ol Owner/ ract A oriz Agent te <br /> � � -- <br /> ( <br />