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� ��ERMIT APPLICAI �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 - DEBIT& CREDIT CARDS ARE NO7 ACCEPTED � <br /> SITE ADDRESS PARCEL TAk I.D.# PERI T# <br /> 2221 Everett AVE, Suite 203 00562660601900 �� <br /> LEGAL LOTNO. BLOCK TRACT <br /> oesc. �q_ �D U <br /> OWNER AODRESS CITY/ZIP PHONE I <br /> Kenneth Dayton 2339 — llth AVE E Seattle, 9R102 � <br /> L ��Kn�i AilI9i,LOfTi tLil/ I <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> P & L General Contractors <br /> Rnn Wallin 360-914-7088 <br /> CONTRACTOR p S L General Contractors ADDRESS CITY2IP PHONE <br /> 3078 Goldie Rd. Ste C Oak Harbor 360-675-6674 <br /> 98277 <br /> CONTR.UCENSE# pLGENC*204QK �nIII�%J <br /> USE OF BUILDING HEAT SOURCE � CONTRACT PRICE OF WORK <br /> cv <br /> Of f ices _Electric �Gas_Other � ��pp — <br /> WORK DESCRIPTION <br /> ���'��, T�n.1t�--T \r�n Pr�uJEv�F� 1 S <br /> . S AJL �- t\ a �'L(X���+� ; 11J4� t��Lu•�(,, W �-fl�\ 5�r�i.iK�.(h S45T (� ^-- <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavalory (wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Ctothes dryer <br /> Laundry tray _ Range hood <br /> 1_ Sink(service/bar/mop/etc.) _ Exhaust fan <br /> BackOow preventer Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain _ 6oiler <br /> Floor drain Refrigeretion <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> � 'EXISTINCo `ISi6� . <br /> i CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whether specified herein or not The granting of a permit does not presume <br /> Urgfve�u�honty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> �construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> �State Co actors Law 18.27 RCW and 296.200 WAC. <br /> i, - � � — y''--t-, Q��s • `�d L GFv. z-z3-oS <br /> Sig ature of OwnenContracrorlAuthonzed Agent Date � <br /> Z <br />