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I <br /> � _ � i Z ��V -�S <br /> � <br /> PERMIT APPLIC�4TION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8870— FAX 425-257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS ; -'�-� PARCEL TAX I.D.# PERMIT# <br /> IQYLi SG C:Vf_RL•'IT MALI. WAY. 6I.DG4 JJ ! 2 G ., " <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS CITYlZIP PHONE <br /> ��1'I'A CQNS'fRUC'fION <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> KEN RORINSON-L•L MSLIE (360)403-7462 <br /> CONTRAC70R ADDRESS CITY2IP PHONE <br /> K061NSON PLUMQING ING 29330 I24'I'll AVG N.G. ARLWG'I ON 98223 (360�103-7462 <br /> CONTR.LICENSE# RO-HI-NI'-�272C2 <br /> USE OF BUILDING I HEAT SOURCE CONTRAC7 PRICE OF WORK <br /> SINGI F fAMILY RGSIDBNCIi _Eledr.c _Gas_Other $2035 <br /> WORK DESCRIPTION <br /> INS'I'ALI. PIRE SPRINKLER SYST6M IN NGW SPR <br /> PLUMSING MECHANICAL <br /> NO. TYPE OF FIxTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <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 /> Laundry iray _ Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer _ Heal pump <br /> Unnal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains O�her_ <br /> Other <br /> � _ �ri �LVAi n�i iu�nn� <br /> � CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know ihe same to be true and corted. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any olh=r state or local law regulating construction or the pertormance of <br /> construdion.That I am authorized by the owner of lhis property to periortn the work for vAiich appliralion is made and I comply with the <br /> State Coniractors aw 1827�y W and 296200 WAC. <br /> -��'r / /C '�li �Z/],t��Q'f <br /> Signature O�edConiradodAuthonzed Agent Da�e <br /> I <br /> ' ---- -- -- ��� <br />