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� <br /> PERMIT APPLICAT�ON <br /> CITY 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 3 �a� ,_O� <br /> SITE ADDRESS PARCEL TAX I.D.N (P�ERMIT# <br /> ��, _ .�.: �,� � 1"L(7SU3 c:J:l�- <br /> LEGA LUT N0. BLOCK TRACT OR SUBUIVISION p <br /> DESC. <br /> OWNER ADDRESS C:TY21P PHONE <br /> �\: �. .�7ti C`�-\'� <br /> . <br /> � ���� Y � �\ \' Y� J� ..\ � . \� ��\"i . i ��� � , .�\ .-� \ ��C„�C�i <br /> TENANT NAME I CONTACT FOR PERMIT , PHONE y��- i��\-%��� ��'� ' <br /> I 1 '�\ �"�-� l �\ :..���_ V. � ��� E•MPJL <br /> NTRA T R AOD9E ITY21P P Oi7c <br /> \\��._.e.c , \��c �\'>��7. �\.�..���C����\ 2�..�.�\� i �i� •�S+ ', >�\ �)�)�J�J <br /> CONTR.LICENSE p ����'`y� ����� ' �� ,� <br /> VAC��7�AC1�1 �� AVC2– ''1�•.71' � , <br /> USE OF BUILDING HEAT SOURCE CONTRACT FR��t OF WORK <br /> .: ..��` <br /> _Electric �Gas_Other ;�� � <br /> WORK DESC IPTION <br /> �� �A� A��AA �AP �, �.�a �� . A � i�C�' . � ` . �'� <br /> d <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A1C–air handling unils <br /> Balhtub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower � Waterheater <br /> Kitchen sink 8 disposal � Gas lireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Water heater Range hood <br /> Sink(servicelbadmop/elc.) _ Exhaust lan <br /> Backllow preventer _ Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Relrigeration <br /> Grease irap _ Woodstove <br /> Rool drains Other <br /> Olher — <br /> CITY OF EVERETT LpCAL SALES TAX CODE IS 3105 <br /> I hereby ceritily Ihal I have read and examined this application and know the same to be�rue and coirect. �II provisions ol laws and <br /> ordinaces governing Ihis type ol work will be complied wilh whether specilied herein or nol.The granting o�a permit does not presume <br /> to give authority to violale or cancel the piovision ol any olher state oi local law regulating conslruction or ihe performance of <br /> construction.That I am authorized 4y Ihe owner of Ihis property to perlorm the work for which application is made and I comply with ihe <br /> State C�clors Law 18 7 R W(and 29G200 WAC. <br /> � ��� � ���� <br /> _ � � <br /> �SignaWre ol ner/Con ractor/Authorized Agent ' a� <br />