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P`�RMIT APPLICATILN <br /> CITY OF EVERETT PERMIT SERVICES a ��_b s <br /> 3200 CEDAR STREET, EVERETT, WA 98201 50 �� p p5 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org S O <br /> APPLI�ATIONS .4RE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS Su t� .2�j PARCEL TAX I.D.# PERMIT#� <br /> %C�l'� EI/_r-� ►.e�-� w� �$D �21� C�� :2o a/6 O �j0/ -� <br /> LEGAL LOT NO. � r:LOCK Tf2ACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> � /(,a/ �/y�"`y1l�t se. ,- y'�7�9 �`t6 0 <br /> 2�t �-{� w � u , �- �3�- f���u�o <br /> TENANT NAM11E CONTACT FOR P[RMIT PHONE <br /> C1 � a � �Lar� �Urvc�IP. s :I�f � � 1M �Ka�2 y.�s��2 i2c� b <br /> CONTRACT —A-1.-.. 5���' �4c��/ADDRESS �'� CITY2IP PHONE �',� r <br /> � <br /> CONTR.LICENSE#'� � �S � ' S� ��`��l`� t��21/�OU <br /> S�1l�N,C �1K � 02c� l I� :D///OS <br /> USE OF BUILDING � HEAT SC..RCE CONTRACT PRICE OF WORK <br /> ��`t-4 � C- — — / � vr� <br /> Electric Gas_Other � �� <br /> WORK DESCRIPTION �Q Ve � �� s�� � ^'��'t— u�' LL 1j K� � <br /> -�JJ 5�c-LL tiew 2LLu� wa t C St� � <br /> � <br /> " C ��n . uZ«✓' w�seLcss <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink f disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br />— Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeretion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Olher <br /> I — <br /> i <br /> jCITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> �� I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ,� ordinaces governing this type of work will be complied wiih whether specified herein or not.The yranting of a permit does not presume <br /> to give uthority to violate or cancel the provision of any other stzte or local law regulating construr.tion or the performance of <br /> cons u tion. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> Sla antractors Law . 7 CW and 236200 WAC. <br /> � �1 � \ i <br /> ' Sig ture of OwnedContract r/Auihorized Agent Date t� I <br /> � 2 I <br />