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P��MIT APPLICATIG.J <br /> CtTY OF 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 FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# � <br /> 2 3 � 7 — �u �7�d-� l'V� �OOS- Qa <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE y� <br /> � V� �/ G,c.�,t � Z3 0? -�u l� �v�• 99Zo / zsz - 9Y3 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> o R �� f�-o �u.��in5 �l/m�/we� /3ozf- �/y`' /l'q2 � i i c�1:.33B- <br /> CONTR.LICENSEM ALG/�/?P/�-�/3ZI3C/ 5�(..' "� 2�� �U� � <br /> �/8Za °f <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �M,�p _Eleclric _Gas_Olher � �� • � <br /> � , ..- �— <br /> WORK OESCRIPTION <br /> 6 �e.. � �s ot.t f JG� '�'- S/�r"-2 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C -air handling units <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) � Gas piping <br /> Showcr Waler heater <br /> Ki�chen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/barhnop/elc.) _ Exhaus�(an <br /> 8ackllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Re(rigeration <br /> Grease irap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certify Ihat I have r�ad and examined lhis applicalion and know ihe same to be true and correct. All provisions of laws and <br /> ordinances governing ihis type of work will be complied with whether specified herein or no�.The gran�ing of a permit does not presume <br /> to give authority lo violate or cancel ihe provision of any olher stale or local law regulating construction or the peAormance of <br /> consiniclion.That I am authorized by Ihe owner of ihis property to perform the work tor which application is made and I comply with the <br /> S�ale n ctors Law,,18. 7 RCW and 296.200 WAC. � <br /> � �z �/ � <br /> i Sign ure of 0 ner ConiraclorlAulhonzed Agent Dale <br /> �_— — --- <br />