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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-8810—FAX 425-257-8857--www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CAR�S ARE NOT ACCEPTED <br /> SITE ADDRESS P/IRCEL TAX I.D.# PERMIT# <br /> I1�{oa E�c-n�,�t w.d.� oe y�f290 o Yo �Ya/ <br /> LEGAL L07N0. BLOCK TRACT <br /> DESC. F,d,y��V N� <br /> ONMER ADDRESS CITY2IP PHONE <br /> ��M,•.�-r �-eaos', ?'�x. Zoo � s� I o�sr. '�Srra�a�.zcc—,,4/2 727/F� C`F7'��o'�-a r�� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Gv�h��-"r TcTSD •��Wz-Y ��aa� 90-7-00�0 <br /> CONTPACTORC�� `,1�21 µ� ��p� ESS E p�w CITY2IP PHONE <br /> `? ,5,-c-A 1��tTi,a..�,zj o�9713c� <br /> CONTR.LICENSE# Cg�--0G-�08�1�.�-1 CS"�e3�4o� -oe'7a <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��� �w�"T ��'�'� _Electric _Gas_,Other � �a1 v�� <br /> WORK DESCRIPTION <br /> -�o�-�ti�O.S �o(L .�A1c �WE�i Tc C$�S �cJ+th�l� �-Jc-cEIL <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FI%TURE OR ITEM NO. TypE OF FIXTURE OR ITEM <br /> _ Toilet A/C-air handling units <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> _ Shower Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gasrange <br /> _ Clo�hes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> _ Sink(service/bar/mop/etc.) Exheust fan <br /> _ Backfiowpreventer Heatpump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floordrain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Rootdrains Other <br /> Other — <br /> r — <br /> CITY OF EVE'3ETT LOCAL SALES 7AX CODE IS 310b <br /> I hereby ceritify that I have read and examined this application and know the same to be!r�e and cortect. All provisions of laws and <br /> ordinaces goveming this type ot work will be complied vnlh whether specified herein or nu;.7he granting o(a permit does not presume <br /> to give suthorily to violate or cancel the provision of any other state or local law regulatir�g�.onstruction or lhe pertortnance ot <br /> construction.That I am authorized by the owner o(this property to pertortn the wark for which application is made and I comply with the <br /> State Cont rs 18.27 RCW 96. WAC. <br /> Sig Wre ner re gent a e <br />