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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 0 AM TO 4 PM <br />SITE ADDRESS <br />L-{OCo (-u`Q_RC--[F WkLL WAq <br />PARCEL TAX I.D. # <br />PERMIT # <br />I '�:)C;605 <br />LEGAL LOT NO. <br />OLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />0__A0_6erLAQO110fflo2S <br />or-< [31MY -or)S Zo., -2bZ-o 0:--) <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />(JC�Ti�IV�t_�Star,) 12 5eJ SiZCkt, (LAC 1JJEECn� Q810� ZLYv Z�'Z�T1Ci� <br />CONTR. LICENSE <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />_ng_15L_ <br />_ Electric _ Gas _ Other <br />�) <br />WORK DESCRIPTION I��Tt.1- O� E r )NTH ��-�- 7 1L6L)M IrJWep <br />�t.� n� �ISG'LA� AQoUE T�f�i�3T c�'FtcE <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 piping <br />_ <br />Shower <br />'Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />Backflow preventer <br />_ <br />Heal pump <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />WoodstovSl`,� <br />_ <br />Roof drains <br />�[_ <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />:)rdinaces 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 perfor for which application is made and I comply with the <br />7theork <br />Sta 'RCW and 296.200WAC5 <br />0� <br />Ignature of 0 ontractor/Authorized Agent le <br />