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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SCRVICES 6��_�7 <br /> 3200 CEDAR STREEI", EVERETT, WA 98201 <br /> 425-257-F810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AUDRESS PARCEL TAX I.D.p PE IT p <br /> 3310 Ches�n�f s�'. a90 3a9 ooi o�boo ��. <br /> LEGAL LOT N0. BLOCK I TRACT OR SUBDIVISION fl <br /> DESC. <br /> OWNER ADDRESS CITVIZIP PI10NE <br /> /�/et.�J�0.n0� �'on.rTr�c f'ion 3300 � I�ts I ►+�t" E�t rc � 5/.i5 <br /> TENANT NAME CONTACT FOR PERMIT PHONE if,Z S S7G ��8� <br /> W rcclfi�y 8all De�•,o%�on SG.�..,. YleU71ahc2 E.,�ai <br /> ��rr . � � , �� j� �r .; � �, ,�in� r' ' � 3�10 C{�rS�.,,.r Sf- �✓rirly� 9RL0/ `�53.�.53/ll <br /> CONTR.LICENSE N <br /> USE OF BUILDING I / HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��+�;�r� . O � �!i-� v f..� r'.' I �/ E�eclric _Gas_Olhor � JU�� ��(P <br /> WORK DESCRIPTION ' /. �, �!�.� � �* V j ti ��^dE /' <br /> ������ ' Iq � � '� �r�t,.� ,. .��i Y1� b 1' � l( t� �T : (' <br /> ✓ �- r . <br /> �Jr; (i /� ' ' t // c.'. . j,' .,('i,s tivit � � <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM NO. TYPE Of FIXTURE OR ITEM <br /> Toilel � A/C—air handling unils <br /> �athtub Forced air syslems <br /> Lava�ory(wash basin) _ Gas plping <br /> Shower W aler hoalar <br /> Kitchen sink R dispos.il Gas Oreplar,n <br /> Disliwasher Gas rango <br /> Clolhes washer Cblhes dryer <br /> Wnlcr hoater Rango hood <br /> Sink(service/badmop�elc.) Exhaust fan <br /> �ackllow preventer Heal pump <br /> Urinal Unit healor <br /> Drinkinc� Founlain Boiler <br /> Floor drain Re(rigeralion <br /> Grease trap Woodstovo <br /> Rool drains Olher <br /> Othor <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS J705 <br /> I hmeb;ceritify that I havo r�ad and examined Ihis application and know the same to ba truo and correct. All provisions o(laws and <br /> ordinaces goveminc�this type of wnrk will be plied with �vhether spocilied herein or not.The granting of a permit does nol presumo <br /> lo yive authority lo violatoAr-�encel the visio of any o�her stato or local law regulalin�construclion or the peAormance ol <br /> construr.tion. Thal I am�'uthcrized b e own r ol this proporty to periorm tho work for which applicalion is made and I comply with the <br /> Stale ConlracMrs La,v 1U.�i RCW nd�0 WAC. <br /> ---�" ;� " % - '� 7 <br /> 4 <br /> Signaluro of OwneN,CoNractod�ulhorized Agenl Oate ''Z <br /> L_.. ... . _ . . . . .---_._.. .----------- --- _ � <br />