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� � — <br /> PERMIT AP�LICATIOI� <br /> CITY O� EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, FVERETT, WA 98201 <br /> 425-257-8870—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SRE ADDRESS Sl•�� �3 PARCEL TAX I.D.# pE9p,�R p <br /> � % r n Wa ��1.�, -v2z <br /> LEGA LOT NO. BLO TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRESS .� CITY2IP PHONE J Lti' <br /> ' /� (�o Ioyk���.�:1�s3o o� <br /> ia -I�C����C�'.t /i� ���1 ISr r�; � I N1G �c e i�'�, s �����.y .�� i <br /> TENANT NAM CONTACT FOR PERMR PHONE <br /> tizs-35'2-69�G <br /> � ,��f Gl, ,�s .7'Q..,�s ��� . <br /> Z`aATFil: Uvv'L E-MAIL Nf��G�:�Co S�i'c��flk� <br /> ��UUC$ �'u�(%{.U.f�' ' �I12. UC�lil�A �,J� �(2S- �3`I- Sf'-Jll <br /> CONTR.IICENSEp � ����� �'�'�`£'t����'A J <br /> wtC(�u�c.�f co3p` (��/e'1�f�', �� R67o� <br /> USE OF BUILDINCz I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> a��a�� _Elec!ric _Gas _Other 3 6 G��3C� <br /> WORK DESCRIPTION <br /> IC AHcu-�G �wnJ�lrGVw.�c.�}' <br /> FLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEAI <br /> _ Toilet A/C–airhandlingunits <br /> _ Bathtub Forcedairsystems <br /> _ Lavatory(wash basin) _ Gas piping <br /> _ Shower Water heater <br /> _ Kilchen sink&disposai Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Water heater Fange hood <br /> _ Sink(service/badmop/etc.) Exhaust(an <br /> _ Backflow preventer Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floordrain Refrigeralion <br /> _ Grease trap Woods�ove <br /> _ Roof drains Olher <br /> O�her — <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this typo of work will be complied with whether specified herein or not.The granting of a permit dces not presume <br /> to give authori�y to violale or cancel ihe provision of any other state or local law regulating cxnstruction or lhe performance of <br /> construction.That I am authorized by the owner�f Ihis property to perform the work for which application is made and I comply with the <br /> State Contracrors Law 182/7�RCW and 296200 WAC. / <br /> i�//�>_¢— �o (f 1r0� <br /> ature o OwnedCoMractor/Authonzed Agent Date <br /> �� <br /> ' z <br />