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� <br /> PERMIT �.i�PLICATION <br /> GITY 9F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED �ROM 8 AM TO 4 PM <br /> SITE ADDRESS �✓erUJi ff/! PARCEL TAX I.D.# PERM�T# <br /> 1 � 6 3 2 . L S �74��- ��3 <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. � (� <br /> OWNER ADDRESS CITY2IP PHONE (`jt GS7 —/ 6 <br /> �c"�un, f� �ark � ��°y sti�A �✓.e w . �/nhw�a� �v/} �'C'=361 <br /> TENANTNAME CONTACTFORPERMIT PNONE I <br /> �2 7(Ct_ ���'o � ` � <br /> �c��� v-� '�`� E�AIL De5'!-Ci ArS'/l ^� /f^ r <br /> C�N i?AC OR ADD ES�S � P p�AE�-- T C o <br /> Wk�`f2 �tSfl ;nc , � �-r ��-- �tWy i� fl L�.r�wau� wf► � <br /> CONTR.LICENSE# <br /> � I,vNi T�U � q �6 cJ p�'' <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric _Gas_Olher �'� vW P� <br /> WORK DESCRIPTION � S � � � G� G h ri D � S��` • <br /> _X-� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OP FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet PJC—air handling units <br /> Bathtub Forced air systems <br /> Lavatoiy(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas firepiace <br /> Dishvrasher Gas range <br /> Cbthes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust far, <br /> Back(low preventer _ Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX COD'c IS 3105 <br /> I hereby ceritiiy that I have read and examined lhis application and know the same to be true and correcl. all provisions of laws and <br /> ordinaces yoverning 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 violale or cancel lhe provision of any olher state or local law regulaling construction or lhe performance of <br /> construction.That I am authorized by the owner of this property to perform the work for which applicalion is made and !comply with the <br /> Stale Conlracfors Law 1827 RCW and 296200 WAC. <br /> � l��(�� ��6�' 7 <br /> SignaWre of OwneP/Contrac t orize nt Dale <br />