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� : <br /> ' ( � <br /> PERMIT APPLICATION , i� � 1 <br /> CITY OF EVERETT PERMIT SERVICES � I� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425•257-8857—wvuw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS PARCELTAXI.D.lt PER ��_ �/ <br /> 2.'l0'l C0� �vf `�'� I -�25-013-ODOFS � <br /> LfGA LOT NO. BLOCK TRACT OR SUBOIVISION N <br /> DESC. �� �� �pZtj <br /> OWNER ADDHE55 CITY2IP PHONE <br /> SKo+dal �v{val �Av�S 2`To�- Co�b� !}ve �U-e�� Q�z�l <br /> TENANTNAME CONTACTFORPEHMIT PF10NE 2(Xp'�{Q(�'�I�j <br /> '�'j�.� I CatheR�ne hxrh�n���la E•MAIL�UNTftNll-l.� (�` � �A' • <br /> CO�'Y1 <br /> �'�,u�,�,� ��900� 132� � NE r�n��►ie 9gz,� �-bs�- �s-i� <br /> CONTR.LICENSE# O Rr,FaQ EG �I Sa�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> o(.�� �UlId1Y10� _Fleciric _Gas_Other � I6i00� <br /> WORK DESCRIPTION <br /> Ins�alla�ic�n a� Z ►xrN�y Cta,binets on exisf�n9 p�a+�'avm on rocrFfoP . <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet _ !VC-air handling unils <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kitchen sink 8 disposal _ Gas lireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clothes dryer <br /> Water healer _ Range hood <br /> Sink(serviceibadmop/elc.) _ Exhaust fan <br /> Backllow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ 8oiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Rool drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I hereby ceritify thal I have read and examined this application and know lhe same Io be true and correct. All provisions of laws and <br /> ordinaces governing ihis type of work will be complied w!Ih whether specified herein or noL The granting ol a permit does not presume <br /> to give aulhority to violate or cancel Ihe provision of any olher s�ate or local law regulating construction or the pedormance ol <br /> construction.That I am aulhori[ed by the owner ol th�s pmperty lo perloim lhe work lor which application is matle and I comply wilh Ihe <br /> State C nlractors Law 1 7 RCW and 296.200 WAC. <br /> O fs S� <br /> Sign re ot OwneriContraclor/Aulhorized Agent Date }/� <br /> I <br />