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. �� ,, <br /> PERMIT APPLICATlON <br /> CITY OF EVFRETT PFRMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,�NA 98201 <br /> 425-257-8810- FAX 425-257-8357-www.everettwa.org <br /> APPLICATIONS ARE ACCEPT=_D �ROM 8 AM TO 4 PM I� � 2 �l(� <br /> SITE ADDRESS PARCE.L TAX I.D.# PERMIT# <br /> 5-61 S-Evcr r��.a o0 3932�2oc�3o� , 1 tJ v- u i�:: <br /> LEGAL LOTNO. BLOCK TRACTORSUBDIVISION/ <br /> DESC. <br /> OWNER tI n ADURESS CITYZP PHONE <br /> �.J�I��c��.r �aw� 1-•U. �a-� �GCL' �0.(�f 9 ��.7� <br /> TENANT NAME � CONTACT FOR PERMIT PHONE�?�_ �/r��/_�3�,� <br /> wl��a� p� I _ ` <br /> c"( �w..� U�� ��Y�..Cv\ eana� �7��fl�l.�+ey-U'A'�N.� <br /> M� �r s�� <br /> T Y 5� 2�g �� 9 � s��fh ,Z 3G�r2�c-�s_ <br /> CONTR.LICENSE f l\A��Se O� G�(� ��TVZI"�uK I v�� � <br /> '� R <br /> USF OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> /� � <br /> �'� _Eleclric _Gas_Olher I y��� 1� <br /> / <br /> WORK DESCRIPTION � / <br /> ��l/''.�w(� ,2 Luc�--ul S<<Q 1.� �� �"�'� � C <br /> �j 0 <br /> 1h5� C�ncw�'� � �o�� Sr, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> 8athtub Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping � <br /> Shower Waterheater ' <br /> _ Kilchen sink&disposal _ Gas fireplace J'� <br /> _ Dishwaslier Gasrange ��,' <br /> _ Clothes washer Ciothes dryer � <br /> Water heater Range hood <br /> Sink(servicelbar/mop/e�c.) Exhaust fan <br /> �ack0ow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Olher <br /> CIIY OF EVERETT LOCAL SALES TAX CODE IS 8705 <br /> I hereby certify lhal I have read and examined this application and know the same to be true and cortect. All provisions of laws and <br /> ordinances goveming this type of work will be complied with whether specifed herein or not.The grz�-�:ing of a permit does not presume <br /> to give authonty to violate or cancel the provision of any other state::�locai law regulating construction or the perfortnance of <br /> constru:tion.That I am aulhorized by the owner o(this property to perform the work for which application is made and I comply wilh the <br /> Statr.�Contractors Law 18.27 RCW and 296.200 WAC. <br /> ���-c I U- 2 �-tv <br /> Signature of OwnedGontr odAu nzed Agent Date I <br /> /z <br />