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P��MIT APPL�CATIG.�i �, <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � �a, �{ �D,s i <br /> 425-257-8810 - F�1X 425-257-8857 -wwv�.everettwa.org <br /> AFPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE61T& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.1r � PERMIT# j <br /> I I30 -� (� S �VC.�'C t l+f4(( Iv.( L 8 �I � 00 �D Z.Z OU I SSG� � I <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORE55 CITY2IP PHON� �y ^ <br /> S-{r;�-('.�s�- [ o��. Zo� // 5t� i3ir<h Sa��rf N��.,x;r�- l3�t�� , G,4- `6SL - 0700 <br /> TENANT NAh1E CONTACT FOR PERMIT � PHONE <br /> ge� 6�-I-�, `� b'eyo,�,A S-f��e. ��Lo�, t, 4zs 776-4Fi3s <br /> CONTRACTOR �` ��y N��N � � ADDRESS CIT'f21i PHONE <br /> � �'1ao !/4-�no,. RD . 3S— <br /> CONTR. LICENSE# �3�r��N��� 7�� � `V� ���� �� i <br /> ` <br /> USE OF BUILDING !iEAT SOURCE CONTRACT PRICE OF WORK <br /> � y i4�o 00 <br /> �"G�q.,� __Eiectric _Gas_Other � <br /> i <br /> WORICDESCRIPTION j,v5'4LG �/) Sr�� O� ��9�t/ GLii.v.c.c� L[K�'S C <br /> �Q � <br /> SieJn� e45;�.e�s Se�i..«..i rn���i•�.y ��Crs '��� I), <br /> ��_. <br /> c� <br /> PLUMBING I MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> i Lavatory(wash basin) Gas piping <br /> � Shower Waterheater \ <br /> ! Kitchen sink&disposal _ Gas fireplace /1„ <br /> � _ Dishwasher _ Gas range �-�n� <br /> _ Clothes washer Clothes dryer .��' V <br /> Laundry tray _ Range hood l� � <br /> - _ Sink(service/bar/mop/etcJ _ Exhaust fan 1� J��� <br /> _ BackOow preventer _ Heat pump � <br /> 'i Urinal Unit heatar <br /> Drinking Fountain Boiler �O � <br /> i Floor drain Refrigeration � � _ <br /> _ Graase trap Woodstove 1 <br /> _ Roof drains _ Other /� <br /> � I _ Olher _ �� <br /> I — ��. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhat I have read and examined this application and know the same to he true d correct. All provisions of laws and <br /> � ordinaces governing this type of work will be co,nplied with�vhelher specifed herein or not The anti�g of a permit does not presume <br /> to give authurity to violate or cancel the provision of any other state or local law regulating const ion or the performance of <br /> construction.That I am au orized by t -o�ntr of this praperty to perrorm lhe�vork fc�hich. pli tion is ade and I corr.ply with the <br /> State Contractors Law�7 R �AC. � `� 1 <br /> i <br /> ✓ '? <br /> SignaWreo OwnenContractorlAuthonzed Agent Date / <br /> �c � <br />