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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICE <br />3200 CEDAR STREET, EVEP.ETT, WA 98201 MAR 0 6 2009 <br />425-257-8810 —FAX 425-257-8857 — www.everettwa org <br />........................................... <br />CITY OF EVERETi <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Engineering/Public Services <br />SITE ADDRESS I PARCEL TAX I.D. N <br />PERMIT q <br />g03 <br />305 SE Cvetett <br />S <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION p <br />DESC. <br />OWNER ADDRESS CITY2IP PHONE <br />6<eentree, Pl�.� I.1.(, IZr-Ill Vr-rN.tusc�_ gluL.l StwJ.;o L�ty <br />91�Oy <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE 360-693-4773 <br />A <br />h\yvl.2f'�G0. <br />Stotts EMAIL rei't.CONTRACTOR '�ua.Rs�r a��o. com <br />Vancouver Sign ADDRESS CITY/ <br />6615 NE HWY 99 Vancouver WA 98665 <br />CONTR. LICENSEp 360-693-4773 <br />VANCOS* 258BC <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I <br />— Electric ._Gas _Other <br />WORK DESCRIPTION <br />oNb 'ill�rv��rLn•--CR•�,, cw.6�n.ei' ��oJYI at 'autp. <br />i <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_Exhaust <br />fan <br />_ <br />Backflow preventer <br />_Heat <br />pump <br />_ <br />Urinal <br />_Unit <br />heater <br />_ <br />_ <br />Drinking Fountain <br />_Boiler <br />Floor drair. <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />_ <br />Roof drains <br />Other <br />_Other <br />- <br />CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br />hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified heroin or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state 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 />State Co tracto s Law�RCW and 296.200 WAC. <br />3/3 �Oq <br />�. <br />Signature of Own r/Contractor/Authorized Agent Data <br />(/2 <br />