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� � � —� � <br /> P�RIIOIfT APQLICA7101V <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 9E201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereitwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# P�RMIT n , " <br /> y92-7 �EvE,�.�a,�,.� w oos8�qooroo iov � ' <br /> LEGAL LOTNO. BLOCK TRACT A <br /> DESC. <br /> OWNER � Qo i��qtiP Prep Ms�, ADDRE55 CINZP PH0�53-SS9-3a'7o �� <br /> � �'� j� n 1�3� g So�.�4-�• Melrose �2 <br /> I�A� ��fc.i -t�� 10Efrifac_��. ��. l�is�n4�Gr4 9 20 8 3 i <br /> TENANT NAME CONTPCT FOR?ERMIT PHONF <br /> �� G lo�a,r. 1�-�o I 'K�a� ` aoc�2 `lzs- z�s-isG� <br /> CONTRACTOR ADDRESS CIN21P PHONE <br /> 'Zr.{-eceNn•noam.. si�.- Cn...pa..i� 17.yi�t Nwy 44� �— Eveve.ti'� QSLo�I <br /> CONTR.LICENSE# � <br /> s,,�-rc a sc9��FQ k �I zs_z�s-�s�"I <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �m�Q��i� ElecMc G2s Olher ��QOOeo <br /> U <br /> WORK DESCRIPTION I • <br /> Thsl,cll�v� :Lhc�..��d.�.cl�.� vka..�.1`�-�d� �.1'�-�rriGL�� ���l�rkl�tc.,�c�. <br /> C.�.A✓1 n�¢.� I2�I-an"S . <br /> PLUA9BING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. T;PE OF FIXTURE OR ITEM <br /> Toile[ AIC—air handling units <br /> Balhtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Ki[chen sink&disposal _ Gas fireplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Laundry Vay Rar�ge hood <br /> Sink(service/bar/mopletc.) Exhaust fan <br /> Backflow preventer Heatpump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby ceritity that I have read and examined this application and know the same to he Vue and correct. All provisions of laws and <br /> ordinaces goveming lhis type of work will be complied with vihether specified harein or not.The granUng ot a permit does not presume <br /> to give authority to viola?e or cancel the provision of any other state or local law regulating construction or the periormance of <br /> construction. That I am auihonzed hy the o�vner of this property to perform the work for which application is made and I comply with the <br /> tate ConU ors RCW 9620D WAC. <br /> i <br /> � i� �-Ca-o Co �t <br /> Sign tu o OwnedCo ractod ut onzed Agent Date ' / <br /> /L <br /> ,_. - — -- <br />