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- ----- PE:( :fVIIT APF'LfCATiU��. �� � �``�� <br /> C1TY OF EVER�TT PERMIT �ERVICES <br /> 32(,0 CEDAF STREET, EVERETT, WA 9P201 <br /> 42�-257-8810 — FAX 425-257-3857 —v�nv�v.everettwa.org <br /> APPLICf4TI0NS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT R CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL i'AX I.D.# ��ERMIT# <br /> �p 2� 5'E e:Ui /.'!/t-� li)/� /-� l$ OS/8 0 03 C?o q va —� � <br /> , � �-�; <br /> .�:� <br /> EGA LOTNO. 3LOCK TRACT <br /> )FSC. <br /> O�VNER ADDRESS CIZ6CPG/V(o-f2i3NE 9G.q�f <br /> 04 P <br /> �ds � �ci' ��Zr /< S Li/� 1312 � �.elcrS�..vr d�✓ � Gchc STa�•c�S �� <br /> TENANT NAME I CON7ACT FOR PERMIT PHUNE <br /> Id/�=N•�y SDIn�.S'o,., ZvC-Y`19-13y 6 <br /> CONTRACTOR ADDRESS CITY/ZIP PHGNE <br /> peni..n�S G�Pw. ST4r Cr•-.T' �S�/ J �12�T�.S�?. .5�� .S-CJ4oM..T1. W.. Zsb-�fyY-t346 <br /> �ONTP..LICENSE# <br /> d� .vlryS G2�3 .v y — <br /> USE OF BUILDING HEAT SOURCE CONTl�ACT PRICE OF WORK <br /> S.- �.5 /r j'sn.-1�� S" JJ' crt ff, <br /> X Electric �Gas_Olher su b 4+s i� �oS o o� <br /> �S: cI'...r?j</ I � O. <br /> WORK DESCRIPTION <br /> i ,�� <br /> �i'<1 '� /J-� G ���,�J'�� C�r L%`{ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilet A/C-air har�Gling units <br /> i BalhWb Forced air systems <br /> Lavatory (wash oasin) ✓ Gas piping - r'�� - �aY,scl f�j'f Q 13 4 <br /> / Shower � Waterhealer E/t . I <br /> i Kitchen sink 8 disposal V Gas fireplace <br /> i Dishwasher Y Gas range <br /> / Clothes washer ✓ Cbthes dryer <br /> Laundry tray � Range hood , <br /> Sink(service/badmop/rtc.) Y Exhaust(an � <br /> / Back(low prevenler Heal pump y <br /> Urinal � Unithealer o ^"¢ �-`/ a"S` 6o`t�� <br /> _ Drinking Fountain __ Boi!er <br /> Floor drain Re(rigeration <br /> Grease trap Woodsiove <br /> � Roaf drains _ Other _ <br /> Other __ - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> — i <br /> i <br /> i hereby ceritify that I have read and examined this application and know the same to be true anG wrrect. All provisions of laws and i <br /> � ordinaces governing this type of work will be complied with whether specified herein or noL The granting of a permit does nct presume <br /> � to give authonry to violate or cancel lhe provision of an�other state or local law regulaling consWcGon or Ihe perfor���ance of <br /> construction.That I am authorized by the owner of this property to periorm �he work for which applicalion is made and I comply wilh the - <br /> State Conlractors Law 18.27 RCW and 296.200 WAC. <br /> � � �� ���� -�� 6/��s I <br /> SignaWre ot Uwned t ctodAuthonzed Agen� Date � I <br /> 1 \�� � <br /> ---- � , <br />