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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.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S — � S p� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> , �20 �/�-�',rP-�� �•)�`�1 l�C�j$I�'I L6Cb2$ ��� 7Ci5 � <br /> , <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> L�e.ti� V-L-�-� �J�.� �-f�tcC�,�;� Co. 1�-(�0 '��'t��,. � �`I j.� �.'�t��-e,iti1� ��G�D � <br /> , � <br /> TENANT NAME CONTACT FOR PERMIT PHONE �� ZG� � . <br /> ��t��ti.S �v� # 1U �12 l�!Gtt6,i D'(�eC��' -(�z�' S� rv��1�KC—�viv���efJ �� c�8 <br /> CONTRACTOR ���,�,^���� xC.�n��CL� tiDDRESS /1�.1 O �� t'G\����TY21P FHONE ' OL <br /> S��u.�-G�,�r[J Z� '� 2�71 `� <br /> CONTR.LICENSEp / IM 7L �� /,) Q�0 j'� C n /�,c <br /> �� .,� !� v ? �JL'Gt�t��2_ �./'� 1 Ol�g <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � � _Eleclnc _Gas_Other <br /> WORK DESCRIPTION �' <br /> i.r,v�i,.y.,i 1 w..t��-Lv�„-w� • /n r.l d �-v v�e.v-� S pvi;,_ic vS�re(o c a i e <br /> �8 �,�)v���1G1�-ti�,�1,y�Gt de-r,�v(.ci�1-., l�� Prki Sh'�� >�ti;,�u-le.v� i n Yz�,.-vci�lt Gl <br /> 1"e,,.cw�k ��w�rw�v-c%�c�...t ��� �in. S i:L u�av� o� p(a �� - <br /> t PLUMBING MECHANICAL <br /> NO. TYPE OF fiXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Balhlub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&dispusai _ Gas freplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Ran9e hood <br /> Sink(service/badmoplelc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove _ <br /> Raofdreins .i Other h+-r Spnnklfy <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �hereby ceritify ihat I have read and examined ihis application and know the same to be lrue and correcl. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whether specifed herein or not.The granting of a permit does nol presume <br /> to give authority lo violale or cancel the provision of any olher state or local law regulaling wnslrudion or the perfortnance of <br /> consWclion.That I am authorized by the owner of this property to perform Ihe work for which applicalion is made and I comply wilh the <br /> State Contrac�ors Law 1827 RCNI and 296200 WAC. <br /> ; �;�l;� F�v"c [,,� �,,�ta(��'C�:'w,����' ���r� .o7 <br /> 9�naWre ot O nedCo raaodAulh rzed A ent r�ate <br /> �� Z <br /> '- --------- - - - - --- <br />