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r <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR[ET, EVERETT', WA 98201 <br /> 425-257-8810-FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I�-a 3/� <br /> SITE Ae7DRESS / PARCEL TAX I.D.# PE IT# � n� <br /> 251.10 �'o1G� � <br /> LEGA LOT NC. BLOCK TRACT OR SUBDIVISION M p�,? <br /> DESi.. v�SZCJ COL��'I UL �1��-�`L�i� /p�DI <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ���i� ���/V�N G ���2TL/CfIC ST <br /> TENANT NP.ME ScfzC�N �"2�ti'n^�G N,tv• CONTACT FOR PERMIT PHONE <br /> . . . . I ^ 3G'z" 3�13 - I�.3� <br /> TOSGIV� /`�lliL�n- E-MAIL �'S� (C�Wi?,f'fP/NS(,��rr� � t.•+ <br /> � � l l <br /> �^-Imi: CU�J.�l�L7FkV�'S SNC- f7(j! U/b�u'IN 319 E. CLl9M<')GN .ST. �1,L/Nc�U�9M 3({l• �]L((, '6ni� <br /> CONTR.LICENSE It ����� 1JA C��'��S <br /> u1��i�s � 9�a10 y-�zofjZ , <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> [lectric _Gas_Other ii'70 �� . o G <br /> — � <br /> WORK DESCRIPTION <br /> �d�� ��"� <br /> PLUMBING MECHANICAL i <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas freplace <br /> Dishwasher Gas range <br /> Clolhes wa,her Clothes dryer <br /> Water healer Range hood <br /> Sink(service/badmop/e�c.) _ Exhaust fan <br /> Backllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Ooiler � <br />� Ploor drain Refrigeration <br /> Grease trap _ Woodslove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have iead and examined Ihis application and know Ihe same to be lrue and correcL All provisions of laws and <br /> ordinances governing this�ype of work will be complied with whelher specifed herein or not. The granting ot a permit does not presume <br /> io give aulhonry lo vioiate or cancel ihe provision of any other stale or Iocai law regulaling consWction or the peAormance of <br /> conslruc�ion. ha authorized by Ihe owner of this property to pedorm the work(or which application is made and I comply with ihe <br />' Slate ntra ors 1 .27 RCW and 2�JG200 WAC. <br /> , 11 �3 � <br /> �nat r of Owne n ctor/Authorized Agent ate , <br /> `�Z <br />