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— � — <br /> � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—w�nnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 5/00 3 F�zr�� ,� vc= 00 - OG3 <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION k <br /> OESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> 3�cN�Jr F�►L �ow A��� �lCts 3 1=i2zD�v �4vE £�/e��-T S�7s- 303 -037p <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> �ClV/�/.L F(?(L 1J IZ-0C.+.:/�,� E-MAIL <br /> ��OATTRACTOR :7i LGH�UK �µJT(�+1G�Ol2 DDR �JG �X ZS7�� TYIZI P r <br /> � K-2R-K V'�i1 j�.5"3�Ycts -72r,s <br /> CONTR.LICENSE# <br /> �S LC.1+ G L 161 i�'t A <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Gas Other �/ �� � <br /> WORK DESCRIPTION <br /> '�L; CUGAT =Cy1/ O r G1rF-5 ,A�tC TL=R <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toile� A/C—air handling unils <br /> �alhtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler heater <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink (service/bar/mop/etc.) Exhausl fan <br /> �ackllo�v preventer Heat pump <br /> Urinal Unit heater <br /> Drinking fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease Irap Woodstove <br /> Roof drains Other <br /> Otlier <br /> — — — I — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this applicalion and know the same lo be irue and correct. All provisions of laws and <br /> ordinances governing this type of work will be comp�ied wilh whe�her specified herein or not.The granting of a permit does not presume <br /> to give au�hority lo violate or cancel the provision of any other state or local law reg�lating construction or lhe performance oi <br /> consiruclion.Tha� I am authorized by Ihe mvner o(this property to perform the work for which application is made and I compiy with the <br /> State CeRlraclors Law 18.27 R and 296.200 Vy�1C. <br /> C �c"� , ���'��,� � 'Z —�G <br /> SignaWre of9 ner/Con�rac(of Authorized Agenl Dale <br />