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Job # �050�9 <br /> PERMiT APPLICATION !� <br /> CfTY OF EVER'�TT PERMIT SEP.VICES �3 n5o2-v I o II <br /> 3200 CEDAR STREET, EVERETT, WA 98201 . ! <br /> 425-257-8810- FAX 425-257-6857-www.everettwa.org -7— a 0-d 5 � <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CNRDS ARE NOT ACCEPTED II <br /> SITE AD�RESS PARCEL TAX I.D.X PERMIT# ' <br /> tl3� $.�.. �VEPEfT MAf1- WA �C� S�i-7`�c I <br /> LEGAL LOTNO. BLOCK TRACT I <br /> DESC. � <br /> OWNER ADDRESS CITYl1JP PHONE <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> 8�0, P�r►; � BEY��p <br /> CONTRACTOR ADDRE55 N.E, CIN/LP PHONE �i�,t�� <br /> MEIZ�T M6�H, Ir1G. ��3o-153Q°,qV6• I�DMoND $$3• �ZZ4 I <br /> CONTR LICENSE# 98073 �I <br /> M612�TMI1b3GM �EV�T(' Ot7389� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK I <br /> Eleclnc 7C Gas Other <br /> WORK DESCRIPTION <br /> G���v� � �►rsrnu� pL�M�►J� F�xr�a�5 A�iv Assoe.��r�v .r�.��P. <br /> I <br /> II PLUMBING MECHANICAL II <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM I <br /> � Toilet _ A/C—airhandlingunits I <br /> Bathtub Forced air systems <br /> � Lavalory(wash basin) _ Gas piping <br /> Shower _ Waler heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood i <br /> . —� Sink(servicelbar/mop/etc.) _ Exhaust fan <br /> � Backtlow preventer _ Heat pump <br /> _f___ Urinal _ Unithealer <br /> 1 Drinking Founlain _ Boiler <br /> �_ Floor drain _ Re(rigeration <br /> Grease Irap Woodstove <br /> Rootdrains � Olher <br /> � other wTf4• HEAT,ER — <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritiy lhat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this type of worM1 will be complied vnth whether sper.ified herein or not.The granting of a pertnit does not presume <br /> ' ro give authonty to violate or cancel ti�e provislon of any other state or local law regulating consWdion or the pedortnance of <br /> �� construction.That I am authorized by the owner of this pmperty to perfortn the work for which application is made and I comply with the <br /> State Contradors La� 827 RCW and 296.200 WAC. <br /> , �.���_s Q���� 7-/2-05 <br /> �', Signature of OwneuContrector/Authonzed Agent Date <br /> I---- <br />