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PERMIT APPLICATION <br />CITY OF EVE�ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEP.ETT', 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 />LOT NO. I BLOCK I TRACT <br />PARCEL TAX I.D. k <br />. J <br />CWNER ADDRESS GITYIZIP PHONE 303 8 y8 i94 <br />$�FD ilJ VAIL �.g(�5 WARb �np.p S��T.eSoo IJJ�FL0.1"ft1q6¢, �A Soo33 <br />TENANTNAME CONTACTFORPERMIT PHONE <br />adoba ?�lex�c.n� 6��u. ���iarr t-�,s ��� 2ob a« i 2-7 i <br />CONTRACTOR ADDRESS CITYfZIP PHONE <br />wl�c.`oX Cor�ST7u�G-r��r� iN� � S�A�e S �bMo�DS WA �'���`/`/�8� <br />CONTR. LICENSE 0 <br />W«-C.oex►94Q�/z//o�;') �'�T qaozo <br />USE OF BUILDING � HEA7 SOURCE � CONTRACT PRICE OF WORK <br />�e5"r��/}rJ'r I _ElecMc }e Gas_Other I / �Z �j � 7 � %Z <br />J <br />WORK DESCRIPTION <br />�sNa^�� IMP�✓er�e,�r F°K- n�e.�..� �+-s�--.av,2�n�-r: <br />NO. � NPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />�undry iray <br />Urinal <br />Drinking Foi <br />Floor drain <br />Grease irap <br />Roof drains <br />Other <br />N0. <br />NPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air sys�ems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />Range hood <br />�xhausl fan <br />Unit FTi <br />Boiler <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />I hereby centi(y that I have read and examined this application ard know the same to be irue and corteC. All provisions of9ws and <br />ordinaces governing this type of work will be complied witn wtethei specified herein or not. The granting of a pertnil does notpresume <br />to give authonty to violate or cancel the provision of any olier state or loral law reg�daing consWction or the performanceof <br />consiruction. That I am.aulhorized by the owner of this propery to peRortn the work fer which applica6on is made and I complywith the <br />State Contraclors Law,1fl27 RCW and 286200 WAC. ,� � <br />27 .�� 0 6 <br />D e 1/Z � <br />