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c <br /> � <br /> PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CCDAR STREET, EVERET'f, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM C'' � �7 "v� <br /> I SITE ADDRESS PAACF.L TAX I.D.tl PERMfI,�# <br /> //1 f_�✓�rLETT l%i,�ll ����A!� p� `'OaOI �SO" � JO�D ' D�''� <br /> LEG� LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER �E; ,ADDFESS CITY2IP PHONE <br /> �OhnA /�i,Qr25NpL. lf� Fi!�R.�,i7 /%'1ALL LU� t� �'P.1'�-LT`i���� <br /> TENANT NAME CONTACT FOR PERMIT PI10NE L1�C- 77S-97� <br /> WCF:�r1lL�5�" ��F'fl(�G 5���'jlOn�.S Joxt� I�,�iC'l191 e•Ma� 9'3C�FA�TSl6N.S,c n� <br /> FAST SIC�1=� <br /> v�qn�l ALD�RGJOvJ MA)! 61J LN;�,,woo�,c��.� �'go3-d <br /> CONTR.LICENSE# r^S��i�� ��' pv I _I� / U �.�," ��r„G, J/'iC� <br /> 1'�'! (. J �� / <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��'���•,� _Electric _Gas_Other � � � �� <br /> WORK DESCRIPTIOiJ � h Q/J G1%AL. L <br /> �Ns�4 �.� iLL�M�r✓AT�t� S � ' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet NC-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(w"sh basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas lireplace <br /> Dishwasher ( Gas ranc�e <br /> � Clothes washer Clolhes dryer <br /> � _ Water heater _ Range hood <br /> _ I _ Sink(servicerbarlmop�etc.) _ Exhaust fan <br /> Backllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Retrigeration <br /> Greasc irap _ Woodsiove <br /> Roof drains Other <br /> Other <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> II hereby ceritity that I have read and ezamined ihis application and knuw the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will ba complied with whether specified herein or noL The granting ot a permit does not presume <br /> to c�ive authority to violate or cancel the provision of any olher state or Iccal law regulating construction or Ihe perlormance ot <br /> ccnstruction.That I am authorized by the owner of this property to perlorm ihe work lor which application is made and I comply with the <br /> Staie Con�r ors l.a 18.27 RCW and 296.200 WAC. <br /> .,._. I�<<�� �f� ���� <br /> Signature ol Ow euContractodAuthorized Agent Da1e <br /> I '/z <br /> �_ - - <br />