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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — I-AX 425-257-8857 — www.everettwa.arg <br />fL0 APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDg�S� � �a// �u PARCEL TAX I.D. # PERMIT # p777� <br />LEGA LOT NO. BLOCK I TRACTOR SUBDIVISION # <br />DESC. <br />CITY12IIP PHONE <br />ADDRE�SS��!f. <br />(�OOW`,NERRJ fy� /� ��/ M <br />ey )tom& �C�1 l //�}% 6E '/�� <br />�CONTACT <br />TENANT NAME FORPERMIT PHONE s, q <br />Slyiaa Rabtnson EMAIL 25S1�G1ECfb'w/->l� <br />NTRAC R ADDRESS CITYIZIP H NE (/Z/,'„yg/�7Z O <br />Yr7wr1 FIr� Protecfion, (yc M 9OX 1z/13 127,, C�-eek/Huh M&Z <br />CONTR. LICENSE # <br />CLnv,)�'I E P0gL l_L <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICEOFWORK <br />Electric _ Gas _ Other lYiw ` <br />WORK DESCRIPTION <br />A�.� L�) 'fie\gab\e., QCZ �e,r�o�1�'r s�r�nkler heoa.S <br />Rep1GCQ, ex�s��ngg"s�no�\a° eti�1°ck loack�low W/ Ames Cold 3ca <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />— <br />A/C — airhandlingunits <br />_ <br />_ <br />Bathtub <br />— <br />Forced air systems <br />Gas piping <br />_ <br />Lavatory (wash basin) <br />Shower <br />— <br />— <br />Water heater <br />_ <br />_ <br />Kitchen sink & disposal <br />— <br />Gas fireplace <br />Gas range <br />_ <br />_ <br />Dishwasher <br />Clothes washer <br />— <br />Clothes dryer <br />Range hood <br />_ <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />_ <br />Backflow preventer <br />Heat pump <br />Unit heater <br />Urinal <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />_ <br />Floor drain <br />Grease trap <br />Woodstove <br />_ <br />Root drains <br />Other <br />_ <br />Other <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ' <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />to the work for which application is made and I comply with the <br />const ction. That I am authorized by the owner of this property perform <br />St onlrac o s I aw 18. and 296.200 WAWACC. <br />Sign lure of Owner/Co o uthorized Agent Date <br />-0)7) <br />