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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 90201 <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.# PERMIT# //� <br /> 1 Z.�DC �1 L�l�'-4� JO <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. � 2 <br /> OWNER ADDRESS CITYZP PHONE I <br /> Sher; S�('��-th '���2 �ces+ �r. kv�re�t 4Ss2�� �2s-��-�ss�} <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Sh�� � SM�� h ISher � Srn�fi�n 42s-�s-I�-► Ssy <br /> CONTRACTOR L �� ADORESS CITY2IP PHONE <br /> IV <br /> CONTR.LICENSE N <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S� � �Electric _Gas_Other N� /�r//9 <br /> i <br /> WORK DESCRIPTION <br /> C..v�v�c � gGcGc�-� � �e��icoorn �,b�:.��+.,c�om . A�i ���s , �.\��e�,���r�� <br /> Pa.,;i�c.+.c�p�u�n..b;�c, ��t.; Si;+� _�i� ��' :�`/ <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �_ Toile� A/C—airhandlingunits <br /> � Balhtub � Forcztl air systems <br /> J_ Lavalory(wash basin) Gas piping <br /> � Shower � �Naterhealer <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry iray Range hood <br /> Sink(service/barlrtiop/etc.) _� Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> F�oor drain Refrigeration <br /> Grease irap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify�hal 1 have read and examined ihis application and know lhe same to be lrue and cortect. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein or not.7he granting of a permit does not presume <br /> to give authority lo violate or cancel the provision of any olher s�ale or local law regulaling conslruction or lhe pertormance of <br /> consiruction.Thal I am authorized by�he owner of this property to perTorni the work for which application is made and 1 comply with lhe <br /> Slate C tractors Law 1 RCW and 296200 WAC. <br /> �� � r. � ,� 5���1���0 <br /> Si of wne��ntra or/Au honze Ag t Da e <br /> I — <br />