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P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425•257-8857-www.everettwa.org <br /> //��APPLICATIONS ARE ACCEPTED FROM 9 AM TO 4 PM 3 � a O`�J <br /> 81TE ADDRESS —Y PARCEL TAX I.D.A PERMIT N <br /> 3a�3 w. CA�Si�n rLD �i - ol C`� <br /> LEGA LOT NO. BLOCK TRACT OR 6UBOMSION N <br /> DESC. <br /> OWNER ADDR S fZl PH E <br /> QOE�NG � <br /> TENANT N0.'AE CONTACT FOR PERMIT PHONE C�^ �p— <br /> �3O�t^'G I L , (�-sT�m 3o�sk <br /> � e�ta� <br /> y�o,.�+��nE►✓ �N�vsr�►,g� <br /> CONTR.LICENSE/ <br /> USE OF BUILDINO I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> W��K S�E�'��� Eleclric Gae Olher 2�8� D� <br /> WORK DESCRIPTION <br /> �ZL�'(.bGA-� gc.�� Fn-or� sfi��� I�� �ro s-r� � � � <br /> I �� <br /> PLUMBING MECHANICAL <br /> NO. SYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tolle� AIC—alr handling unils <br /> 8alhtw Forced elr systems <br /> Lavalo� wash basln) _ Gea piping <br /> Shower Water heater <br /> Kilchen sink 8.1lsposal Ges tireplaco <br /> Dishwasher Ges range <br /> Clothes washer Cbthes dryer <br /> Water healer Range hood <br /> Sink(servicefbar/mop/elc.) Exhausl fan <br /> Backl!ow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain � Boller <br /> Floor draln Refrigeratlon <br /> Grease trap Woodalove <br /> Roof drelns Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS JiOS <br /> I hereby cerilily lhal I have read end examined lhis applicaUon end know the seme lo be lrue and wrrecl. All provlsions of lews end <br /> ordinaces govorning lhis lype ol work will be complled wilh whether speclfied hereln or nol.The grentinp of a parmll does nol presume <br /> lo give authodty to violale or cancel tho provlsion of any other stale or local law regulatlng construcUon or lhe peAormence of <br /> conslruclion.That I am aulhonzed by Ihe owner of this property to peAorm lhe work(or which applicaUon Is made and I comply wlth the <br /> Stal Contractors Law 1 7 W a d 6.200 WAC. <br /> �� � " 3�'��'9 <br /> 3gnaWre of Ownerf ontractor/Aulhorized Agent ate I/L <br />