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PL�MIT APPLICATI���I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org n�� ,/OQ_ �7 <br /> j' �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 3 CREOIT CARDS ARE NOT ACCEPTED <br /> SITE ADORESS PARCEL TAX I.D. # PERMIT�1 <br /> 1333 Cr+as�� sT y 383a�6 oD4ioo aq -ol <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. 8 � ', LP�\ OF Ev�eE:z� 0'�V /• 11 <br /> OWNER ADURE53 ITY IP PH NE <br /> NA�.K c�S. Cd►�s�. �aa �-r+�n�c. uE E�e�e+� �1ns yzS 341-�360 <br /> TENANT NAME I C0�1 FOR^RGM�IT PMONE <br /> H.� �� ti2s aw-a�a�q <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> I�AACk Q2oS COuST ;�q�,a s'�'/�c �vE �v�ere+t q��oS p?S 3q7-7360 <br /> CONTR.LICENSE N <br /> NAAc.kQ'��i �,'D'Z <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> 5�1_ _Electrlc �Cas_Other �QQ � <br /> WORK UESCRIPTION <br /> Sfil� <br /> /�is <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF F�XTURE OR ITEM <br /> � Toiiet A/C—alr handling unlls <br /> — Bathtub � Forcedalrsyatems <br /> Lavatory(wash basin) Gas pipinp <br /> Shower Water heater <br /> � Kftchen sink 8 disposal Gas flreplece <br /> Dishwasher � Gas renge <br /> � Clothes washer L Clothes dryer <br /> _ Laundry tray Ranpe hood <br /> _ Slnk (service/bar/mop/etc.) � Ezhaust fan <br /> _ Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boller <br /> _ Floor drain Ra(dgeratlon <br /> Grease trap Woodstave <br /> = Root drains Othor� <br /> Other ' <br /> CITY OF EVERETT LOCAL 9A1E9 7AX CODE 19 3105 <br /> i I herehy centify that I have read and examined this applicatlon and know the same to be true end corred. All provislons af lews and <br /> ordinaces govoming this type of work will be complied with whether specified herein or not.The granting of a permit daee not preaume <br /> to give authority to violate or cancel Ihe provision of any other state or local law regulating canatructlon or the performence of <br /> I construction. t I am authonzed by the owner of this property to peAorm the vrork for wh�ch applicadon is mede and I comply with the <br /> State ontracro aw 1 .27 RCW d 296.2 WAC. <br /> - 3-0 <br /> Sign ure o nen ontractonAu ge ate <br /> �L <br />