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. t . <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.A PERMI M ' �� <br /> 0�721 EV�IZG�N Why 2eo'1240�203300 — <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CI�fL,ST/�P� RoD CHR�STIRNS��1 C�zs) 67o-19d8 <br /> CONTRACTOR ADDRESS CITY2IP PHON <br /> LoD�S'Th� �o. 66os 2�z- sr. sw��ti��� !yzs 6�0- �qd8 <br /> CONTR.LICENSE M r ^t�rC p/�1',iJ K(� <br /> LJ✓U�J��lJ —1 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> c� <br /> F�{�O �£j� p���R _E�ectric �Gas_Other ��y�6�y' <br /> WORK DESCRIPTION <br /> R�PLhC� �6��A, Gh5 U►JIT F1�T�R.S WITH (6 a4. 6kS RAMAAJT <br /> t��h�s. wc�u�.s �ns prP��vc RL�h�-►�a►a.s, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXI�URE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> Toilet _ A/C—air handling units <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) � Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/badmopletc.) _ Exhaust fan <br /> BackOow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _. Boiler <br /> Floor drain _ Refrigeration <br /> Grease trap Woodstave <br /> Roof drains � Other PJsAI AN7 H�hh�� <br /> Other — <br /> CRV OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 hereby cerilify lhat I have read and examined lhis applicalion and know the same to be true and cortect. All provisions of laws and <br /> ordinaces guverning ihis type of work will be complied wilh whether specified herein or not.The granting of a pertnit does not presume <br /> to give authority to violate or cance�lhe provision of any other state or local law regulaling construdion or the perfortnance of <br /> construction.That am authorized by the owner of this property to pertorm the work tor which application is made and I camply with the <br /> State Co ra tors w 18 27 RCW and 296.200 WAC. I/�/O! <br /> ; , � (�o�� �1 � <br /> Sign e o O er/C ntractod u horized Agent Dale <br />