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PERMIT APPLIC:ATg'ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8310 - FAX 425-257-8857 - vvvAv.everetVva.org `� <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />9/&i �25 orrM4�,& N �1gao30(,lOno <br />LEGAL LOT NO. BLOCK TRACT p/ _�C <br />DESC. l <br />OWNER ADDRESS CITY/ZIP PHONE <br />M 40 � 1 k44 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />/4A '4Z5 <br />k/RK 446-1-11S 193 • /778 <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric 4x— Gas _ Other <br />I <br />WORK DESCRIPTION ,r 6jl96 AC-4GA4 y7JT- G?W- 7-148 Q(($%/Aia <br />�ul�nrN6 Wr 74 /-*'-j R6A1z,- AUIL4>1N6 ARf-Woxrn147e&-�- 7,700 <br />54)UARC, rFeT /AJ 4*J,0 ,45VW,6re'11D [cW�stpP�F � <br />/94ar—t W 6 . <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C - air handling units <br />Bathtub <br />_ _ <br />Forced air systems <br />_ <br />Lavato y (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />C-s range <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backfiow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <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 />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 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 aulhorizrd by the owner of this property to perform the work for which application is made and I comply with the <br />RCW and 296.200 WAC. <br />TatCDrs.27 <br />S o wner/Contractor/Authorized Agent Date . , <br />L <br />