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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 />SITES ADDRESS <br />305 SC <br />PARCEL TAX I.D. # <br />J ly j3C)e/306 <br />PERM)T # <br />1 5 d �3 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />6,et,.JrPC' P 2 /7/ d LLC lAV Uei 13/r d _J LA",C,i^/. CQ e7m-o5, <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE �iJ5�776 -5g3.3 <br />1- li4 ! fiL,Y. W <br />(>tC/1 Q G�J(�I ST EM,-f '.7 arc •>'1 SCcn <br />CONTHALNUK <br />rrl# ifleat 5,9,, $ysie.,a5 %yGi> Fk,r s0.� Q«j E,.e _ifs t✓4 9`SAOY (-f.Z 77� -8335 <br />CONT LICENSE # <br />13 ERRY/VCC, 7 7G,1 l <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />[//� �1 <br />CCI.(1MG:IC 14( IBC IQI I <br />— Electric Gas _ Other <br />I <br />WORK DESCRIPTION00 y , 4 pry �� I�% 1a,i.4C / IeACIJ,3 <br />T e �r n f�a wi r� era wq.�44 <br />-. W00ji, L77 4oL,,v,0, <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />_ <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 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 />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 authoriq to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />conslruclio hat I am a lhorized by the owner ssf this p perty to perform the work for which application is made and I comply with the <br />State o actors Law .27 RCW d 296. jYz4C. <br />g toe of Owner/C actor/ u orized Agent Date <br />I <br />