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-- _ . � . <br /> � PERMIT APpLICATION <br /> CITY OF EVERE`�T PERNiI�' 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 �9�'9 PARCEL TAX I.D.# PERMIT# <br /> C��v �✓��re. (� �l�t�l w�� �urc c✓h 23Gsltv'oo3G S� C�c�.-n,� 4 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> 3 OWNER ADDRESS CITY2IP PHONE <br /> �-�'-E'' GL"r'fR,:�-e.Q <br /> TENA�T NAME CONTACT FOR PERMIT PHONE <br /> S j ,� ��j I K:.-1 Hun��<<�I Lew:s 77G �Yy�'S <br /> CONTRACTOR �`1� ADDRESg CITY2IP PHON[ �{�� 77L <br /> ��W" n 7�lLX� NarcPPSOyI R<� C✓eIti'(�" u/`t 9�2�'3 �b'3.S <br /> CONTR.LICENSE# 1��f r� �(. �� � 7 G ,M <br /> USE OF BUILDING HEAT SOUkCE CONTRACT PRICE OF WORK <br /> 1 �j C�7 <br /> �Z� .0 e �U�lectric _Gas_Other ,T-/ / S � <br /> WORKDESCRIPTION �yiSf2� �( � S � C � G� .+r l Si��%� �'2 �`•i � t�'P '/oG� <br /> �-� B�� , I�•�n� � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Balhtub Forced air syslems <br /> L�valory(wash basin) Gas piping <br /> Shower W ater heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clolhes dryer <br /> Water heater Range hood <br /> SiN�(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer Heat pump <br /> U'rinal Unit heater <br /> Drinking Founlain Boiler <br /> � Floor drain Re(rigeration <br /> Grease lra� Woodstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y lhat I have read and examined this applicalion and know the same lo be true and correct. All provisions of laws and <br /> urdinaces c�overning this lype of work will ba complied wilh whelher specified herein or not.The grar�ling of a permit does nol presume <br /> Ito give aulhority to violate or cancel the provision of any other state or local law regulating construction or lhe pedormance of <br /> construclion.That I am aulhorized by the owner of this property to perform lhe work(or which application is made and I comply wilh lhe <br /> Slale Contractors Law 18.27 RCW and 29G200 WAC. <br /> Signature o(OwnedConlractor/Authorized Agenl Dale / <br /> ,� z; ) <br />