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P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810– FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM !� � 3-O—�f <br /> —f-- <br /> SITE ADDRESS Ct X(ZCZT , ki� `j F LC I PARCEL TAX I.D.N PERMIT# <br /> �_�i 2� Ct� r� 5�-rt.�T <br /> ,�Vl 9/l � G� .� <br /> LEGA LOi N0. 6LOCK TRACT OR SUBDIVISION N <br /> DESC <br /> OWNER ADDRESS CITYIZIP HONE �L�� <br /> L(1CC `1 2�'X M �LLE� L4i`t ccnq2 s�Ki �u�-2C7T,�.� ���i-�z� !"r <br /> `1 c'Lc;i <br /> TENANTNAME CONTACTFOR PERMIT PHONE <br /> � � �� E-MAIL <br /> 1'I M NA S� 22 pE � �q 65+1� AU E Nf ,�Mcys,�,wE a�� <br /> CONTR.LICENSE pNAM B�y�2�� �� Z�v �S�'� I�� <br /> USE OF BUILDING - HEAT S4URCE I CONTRACT PRICE OF WORK <br /> � � � �55G � <br /> �.'( �.i�p( f��l ( , _Eleclric �Gea_Olher <br /> WORK DESCRIPTION T <br /> �i�l'; i'ii�iti)C, ��v �JFlIL,��� Ca�"� k=�r�6E F�c,M C �,��t�,7� <br /> ��i�13 Pi�'ir.,Ci �ti, II�c.6E <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TVPE OF FI%TURE OR ITEM <br /> Toilet _ A/C -au ha�iling unils <br /> BathWb Forced air sys'ems I <br /> Lavalory (wasn basin) � Ges piping I <br /> Shower . __ Water heater . <br /> Kitchen sink 8 disposal Gas fireplace � <br /> Dishwasher � Gasrange <br /> Clolhes washer ' . _ Clothes dryer <br /> Waler healei _ Range hood <br /> Sink(scrvicelbarhnoplelc ) _ Exheust lan <br /> Backflow prevenler _ Heal pump <br /> Urinal __ Unil heeter <br /> Drinking fountain _ Boiler <br /> Floor drain _ Reingeration I <br /> Grease trap _ Woodsto��e � <br /> Rooldrains _ O�her__ I <br /> Olher — ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE 19]106 � <br /> I hereby certlty Ihat I have read and ezammed Ihis applica!ion and know Ihe same to be true and correcl. All provisiona ol laws end <br /> ordinances goveming this rype of work will be complied wilh whelhe•specified herein or not. The grenling of a permit doe6 not presume <br /> lo give authonly lo violate or cancel�he provision ol eny olher etr,�e or local law regulati��g cons�ruclion or Ihe perlormanr,e of <br /> construcuon. Thal I am authon¢ed by the owner of lhis property lo peAorm the work Ior which epplication is made and I compty with lhe <br /> Sta�e Con�raclors Law 18 27 RCW and 296 200 WAC. <br /> �L=i7 _ ll 'l Q�_ <br /> Sign , v��o trac odAuthonzed Agent ale <br />