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�- - <br /> �--f 'c�Ml i�' APPL� !�A�i`a�:��� ,:: <br /> �!3'V �� EVE�'�T3' t'�REt!!9�' 5�6�,�ru��Jr�` <br /> 3200 CEDAR STnEET, EVERETi', WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE61T R CREDIT CARDS ARE NOT ACCEPTCD <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT iF <br /> (� Sc.=��'n M'i2L ��� � � Si�ca-ov� <br /> LEGA LOTNO. BLOC TRACT <br /> DESC. <br /> OWNER AODRESS ' CITYIZIP PHO�iE <br /> TENANT NAME CONTACT FOR PERMfT PHONE <br /> �-�`�c,-n.t�y G�c�„/ F'�,� tilzs . �a� , � i e� <br /> CONTRACTOR � ADDRESS CITY2IP PHONE <br /> 41,s". 33c 8/!e n <br /> g'�3�'( StGn) S�7'LU�ccf, ibz�2 Z?�M� �.v�z. H-v�, Mi�� N/Lc-=�, w� 9k�� 2. <br /> CONTR.LICENSE# �8�,S�S��� O PC� //]S�y <br /> USE OF BUII.DING I — FIEAT SOURCE I CONTRACT PRICE OF WORK <br /> 0 <br /> Electric Gas Other '� g� Z� <br /> WORK DESCRIPTION <br /> I�/Si�7�� w�l 5/co.�l /i-n�9 4-k�oic �r�P T� t.�c.tsn�✓G, �cwvx _ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXiURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A1C—air handling unils <br /> Balhlub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Laundry lray Range hood <br /> Sink(servicePoadmop/etc.) Exhaust fan <br /> Backflow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Fioor drein Retrigeration <br /> _ Grease trap Woodstove <br /> Roof drains Olher s� �.� <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify that I have rcsad and examined this applicalion and know lhe samo to 6e true and correct. All provisions of laws and <br /> ordinaces govaming this type of work will be complfed wilh whelher specified herein or noL The c�ranting of a permil does not presume <br /> lo give authorily to violate or pncel the provision of any other slate or local law regulaling construclion or lhe performance of <br /> consWction.Thal I am author¢ed by lhe owner ot this property to perform lhe work for which application is made and I comply with the <br /> Slata Contractors Law 1 ;RCW and 296.20D WAC. <br /> �,;� <br /> � �/' F�� <br /> Signature ot Owner! tracror/Authonzed Agenl��� Oate <br /> �L � <br />