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F ;�MIT APPLICATI.,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRQM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �9oY w G-,�kks�. fv�.7T- w�t m�po'-� - Z>33 <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> Kkr* �NNhi c� y70'r W Gle��+,vek �vc�n.lr' ut4 <br /> y9�e3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> (3e�k's r�NrN.u� T�� 29�a I37T`�um � �p1� S��,s �l2r�.Z3/-ypio � <br /> CONTR.LICENSE M W� y�yp� <br /> �rzr-3r3-��S <br /> USE OF BUILD�NG NEAT SOURCE I CONTRACT Pelo E OF WORK <br /> _Electric �[Gas_Other � �j-00� �} Th� <br /> WORK DESCRIPTION <br /> 1asT�/ �43 `p,•�e -�ro�n Ylc�-w 'y'� bo t!w <br /> T 7%1! �!e'� G�3 6 o i I� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. IYPE OF FIXTURE OR ITEM <br /> Toilel _ A/C—air handling unils <br /> Bathtub Forced air syslems <br /> _ Lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Walc�r heater Range hood <br /> Sink (service/bar/mop/etc.) Exhausl fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fow:!ain � Boiler <br /> Floor drain Refrigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby certify lhat I have read and examined thia appiicaticn and know the same lo be true and correct. All provisions of laws and <br /> ordinances goveming ihis type of work wili be complied with whether specified herein or not.The granting of a permit does nol presume <br /> �o give uuthority to violate or cancel the provision of any other state or local law regulating construction or the perfortnance of <br /> construclion.That I am authorized by the owner of this property lo peAorm the work(or which applicalion is made and I comply with the <br /> State CoMraclors Law 18.27 RCW and 296.200 WAC. <br /> -� �/U <br /> i r ne nlrac or/Au�horized gent Dale <br />