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� � ` . <br /> � ` <br /> PERAIIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettn+a.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM <br /> SITE ADDRESS .{�- PARCEL TAX I.D.# PERMIT# <br /> ee s� 9`9 E��`Q�4�1� Z9- o -oz 3�0 3 t� Pa�7�ooti'tx� 7 <br /> LEGA LOTNO. BLOCK 7RACT <br /> DESC. <br /> ADDRESS CITY/LP PHONE -� <br /> OWN R � �zo � ���d a��� ���,M� cA �- ��e� 2��- - <br /> Gt/l.l /�aN4AE/Ytl/v izoz <br /> TENANT NI'ME � � i CONTACT FOR PERMIT PHONE <br /> QL,�,� Z.�1� S 7 <br /> CONTRACTOR �a�e�- ��, t' �C ADDRESS pZ I��{ It�'�l PL�CmZ��e��ONE��aO(f <br /> _� <br /> CONTR.LICENSE R `�i- ��C 1 Q�Sm� <br /> v <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �D m r�1 e/�C/,� � — <br /> Eledric _Gas_Other z�' ��� <br /> WORK DESCRIPTION // / � � /' �� + L �� lY <br /> �G 7� r � I � <br /> �^� <br /> � �,_�.,, l� ' I , <br /> PLUMBING MECHANICAL <br /> NO. ' TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � T iiet _ AIC-airhandlingunits <br /> " B thtub _ Forced air systems <br /> � vatory(wash basin) _ Gas piping <br /> � S ower _ Water heater <br /> Ki chen sink&disposal _ Gas firep�ace <br /> Di hwasher _ Gas range <br /> CI thes washer _ Clolhes dryer <br /> ndry Vay _ Range hood <br /> 3'[ Si k(service/bar/moaletc.) _ Exhaust fan <br /> 8 flow preventer _ Heat pump <br /> U al _ Unit heater <br /> D king Fountain _ Boiler <br /> FI r drain _, Refigera6on <br /> Gr ase trap _ Woodstove <br /> R f drains _ Olher <br /> O er — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I herkby ceritify that I have read and examined this application and know the same to be tnie and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether spedfied herein or not The graMing of a pertnit dces not presume <br /> to give authority to vioiate ncel the provision of any other state or local law regulating construction or the perfortnance of <br /> wnstructi n.T t I am th ize y th owner of this property to perfoim the work for which application is made and I comply with the <br /> State C tra rs Law 0. RC 200 WAC. <br /> Z 7 (/� <br /> ture o er onVadorl uthorized gent Date I <br /> � r <br /> _J <br />