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PCRMIT APPLICATIUN ' <br /> ClTY OF EVERETT PERMIT SERVICES , � I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org � �I <br /> C , <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1�/'O�� <br /> SITE ADDRESS c,. 1 PARCEL TAX I.D.# PE MI �# y— <br /> ���� C�\G�� ' ; a , ( C� ' �,1 C�b`'�- �'� � L�O ���D6 �l�/ � <br /> LEGAL LOTNUO. BLOCK TRACT C <br /> DESC. r���i�() J (�1�it'1' � C� I 1 � L�1�� Ye . <br /> OWNER ADDRESS CIN21P PHONE �ZS <br /> �,� C� ���.eti�� 15�o C.Li¢,o�iut-� ��c. �A�e� �zb 1 a 5a a''f� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> St��.�►�G q���n II uasa��3H� <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE p <br /> USE OF BUILDING H[AT SOURCE CONTRACT PRICE OF WORK <br /> / � �y��� � _Eloctric V Gac_O�hcr %LIZC/C <br /> l.� <br /> WORK DESCR TION <br /> . <br /> I-� � �� o��e° c�.�,<< rtirlace ews � ���� ���Lv�Lc�e. . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet A/C-�air handling'unils <br /> Bathlub Forcod air sysloms <br /> Lav�lory(wash b�sin) ��_ Gas piping <br /> Shower Water heater <br /> Kilchon sink 8 disposal _ Gas lireplaco <br /> Dishwashcr Gasrango <br /> Clolhes washer Clothes dryer <br /> Walcn c�ater _ Rango hood <br /> Sink(servicelbar/moplelc.) _ Exhaust fan �� <br /> Backlb�v preventer _ Heal pump �� ��a � <br /> Urinal _ Unit hoater � (�� <br /> Drinking Founlain Boller ppp <br /> Floordrain _ Rofrigeration �11 N�, <br /> Groase Irap _ Woodstove v 1v <br /> — Other � <br /> Roof drains <br /> Othcr _ — <br /> CITY OF EVERE7T LOCAL SALES TA)(CODE IS J105 <br /> I hereby cerilify that I havr, read and ez�mined Ihis application and know the same lo be true and correct. All provisions of laws and <br /> ordinaces yovoming Ihis type of work will bo complied wilh whelher specitiod hnrein or noL The graNing of a pormit does not presumo <br /> I to give aulhority lo violate or cancel�he provision o(any olher sta�e or local law regulating wnstruclion or lhe peAormance of <br /> r.onslruction.Thal I am authorized by lhe owner o(this property lo periorm Ihe work for which applicalion is made and I wmply with lhe <br /> Slalo Conlrer.lors Law� �F2CW and 296.200 WAC. <br /> �� , � i-/C C� <br /> Sie�na re ol OwnerlContractodAulhorized Agent Datc+ <br /> �/Z <br />