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PERMIT APPLICATI(AV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA J8201 <br />425-257-8810 —FAX 425-257-8857 — www.ew.rettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />� <br />35 SE Zva;r_c-j-r r+n1.1_ w'Ay wnf�iS21: i <br />L C�* ,0_ <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION f! <br />GESC. <br />OWNER ADDRESS CITY2IP PHONE <br />I�;i_L P� 2A yE Et1��tiT � (J000L �J7�- <br />- <br />TENANT NAME NRi <br />CONTACT FOR PERMIT PIIONF>\,(25 / r)7 • 8-zr— <br />' i'{_uNG V'+ET N6UYE1v <br />E-MAIL YiET NC;+Y7(:ni [• �"fit <br />C NTR T R ADDRESS CITY/ZIP PHONE <br />iAIGC ICg b v�UncrZ •�5 '� LvcRFT MAIL klA`j.�# lob <br />CONTR. LICENSE# un.� .Dtr^c. �— - <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Ntt'IG :> AN b Sf A <br />Electric Other <br />I <br />�ajo <br />— _Gas <br />WORK DESCRIPTION <br />�, F�F cTM Cst,'� �l•i,r`�ana C6L� 1-0 <br />r,Cu.ht 6ro� I a,J-d.; �Y-� <br />0 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C - air handling units <br />_ <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />_Gas <br />fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />� <br />Water healer <br />Sink (service/bar/mop/etc.) <br />T� <br />Range hood <br />Exhaust fan r <br />— <br />Backgow preventer <br />I <br />Heal pump L' <br />� <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />\n rrc <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />_Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cedtify 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 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 Contractors Law 18.27 RCW and 296.200 WAC. <br />Signa re owl caner/Co tractor/Aulhorizod Agent Date <br />7. <br />