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{ ; <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.ora <br /> . <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � �. Z7—D S <br /> SITE ADDRESS " S - PARCEL TAX I.D.# PERMIT X <br /> 'Spo",�� (,�, lNC'� ('�n �Z "�� <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION� <br /> DESC. <br /> OWNER ADDRE55 CITV2IP PHONE <br /> (fiEIN �� <br /> TENANT NAME CONTACT FOR PERMIT �/P�RyOpE�G�n'�'/ <br /> /� ��-� �� �4 <^�.��, <� 7 <br /> I) �� " 1�r 2.Sk� E�MAIL <br /> --�aEs� a <br /> ONTR.LICENSE I l I�� ���l��� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��.��-T n'� r�U Elecirlc Ges Other ,�G-RSl►{J ��'� <br /> WORK DESCRIPTION <br /> �r�n�5r�- ��-f N� � MorO�. ��E �i�r�ro�c 131,p�, '3ox ..� <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> Toilet A/C-eir handling units <br /> Balhtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Watei heater <br /> Kitchen sink 8 disposal _ Gas lireplace <br /> Dishwasher _ Gas range <br /> Clothes washer Clothes dryer <br /> Waler healer Range hood <br /> Sink�service'bar.�mop'etc l __ Exhaust fan <br /> Backllow preventer __ Heat pump <br /> Urinal _ Unit hoa�er <br /> Drinking Fountain _ Boiler <br /> Floor drain _ RelrigBre�iOn <br /> Grease trap __ Woaistove <br /> Rool drains _ Other <br /> -- Other- __-- — ! <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�705 <br /> I hereby ceritity that I have read and examined this application and know Ihe same ro be Ir�e and wrrect All provisions ol laws end <br /> ordinaces goveming Ihis type ol work witl be complied with whether specitied herein or not.The granting ol a permit does not presume <br /> to give aulhorily'o violate or cancel the provision ol any othar state or�ocal law regulating constmction or the peAoimance of <br /> constmclion.Thai I am authorized by Ihe owner ol Ihis property to perform tha work lor which application is made and I comply with the <br /> State Gpntractors Law 18.?�/R/CW a/nd 2 6.200 WAC. / <br /> 1��.n ,, .,� , �1 j y'l(�r"I�� /r�//� (��' <br /> Signature o nen onVactor' ut ionze gent �� ate I( Z <br /> I _ . . . . . . . . ----_ .__-------------- --- <br />