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r <br />1 <br />PERMIT <br />APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE rT, 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 <br />PARCEL TAX I.D. A <br />PERMIT # <br />35 sIE E4E2ETT <br />m4 020/ c.�o L. <br />) <br />LEGAL LOT NO. <br />BLOCK <br />TRACTOR SUBDIVISION # <br />DESC. 3 AND A <br />13 <br />_j- r 3l OT J <br />OWNER ADDRESS CITYIZ(P PHONE <br />cN��a3AcGee= EvE*Le-r-r MR�L- <;c, ',c LaECET1 [dcaErr (N2S)347-fiKyy <br />LLc <br />r"FlL L my -it I�t 9rfzo8 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE HZS -347- 8t{4 a/ <br />gEL,A �AS>•1Sa+J <br />-HE�6A2fTE2 <br />I TnD EeCONTRACTOR <br />ADDRESS CITY/ZIP <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Jnij 3 - GLoTHTlJEj SAES <br />I <br />_• <br />prop t 2. - No JSii VET <br />_Electric _Gas _Other <br />WORK DESCRIPTION <br />:1-n gjMl u. C>iJioiQiCT WAIx. >7ET 0EEiJ iJNSTSr � ��1(OCJYI'1(h'�3)/ <br />And r�iCe L*,l03) <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />I <br />Toilet <br />A/C - air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />as asher <br />Clothes dryer <br />1 <br />ater <br />Range hood <br />icelbar/mop/etc.) <br />Exhaust fan <br />_ <br />_ <br />preventer <br />Heat pump <br />Unit heater <br />FountainBoiler <br />inRefrigeration <br />ap <br />Woodstove <br />nsOther <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances 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 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 Contractors Lew 18.27 RCW an 6.200 WAC. <br />Signature D Owner/Contractor/Au ooze gent Date <br />