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7 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS °'Sf 5""6 <br />PARCEL TAX I.D.# PERMIT#2 <br />/ oz Z_ EveCok Mn.X� W,, <br />i �/J�ir <br />LEGAL LOTNO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />p <br />F�rere�t MAXX /G/O2- $6 £/er -X 11" \M WPu £.reretE IgZOP � 22-71 Sy <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR �jV�ST(.k,1�;,,�r j,.t[, ADDRESS CITYIZIP PHONE 5-S-y57-3(.? <br />CONTR. LICENSE d• <br />MSICoZ+io99QE I Sol S le- prvP-- \IAI:'rMa v'/�. 989oz <br />__ <br />USE OF BUILDING HEAT SOURCE <br />_ <br />CONTRACT PRICE OF WORK <br />_Electric Gas Other <br />(CJ2rX•�9 <br />WORKDESCRIPTION ZQ,MD�\ tX�Si+'-+y 5(�4uz-IrJ[I-.an "I¢v+ S-}e�C�,,./J/,./X-r gf•GI <br />-7Z,z_Sc eX.S+`"r9 {�A� <br />o 1,,.•�k-,�7 ex,si;� <br />PLUM 31 G <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE- OF FIXTURE OR ITEM <br />-_ <br />Toilet <br />A/C - air handling units <br />_ <br />Batntub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water healer <br />Kitchen sink & disposal <br />_ <br />Gas (replace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />Sink (service/har/mop/etc.) <br />Exhaust fan <br />_ <br />BackBow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />_ <br />Other_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cedlify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates 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 other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contractors Law 18.27 RCW and 296100 WAC. <br />po. wner/ �7D06 <br />of <br />5 me of�wner/ConVaclorlAulhodzed Agent 'Date <br />Y2 <br />1 <br />