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rERMIT APPLICAI ��N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARpS ARE NOT ACCEPTED <br />SITE NDDRESS <br />531 /Ylc�iso� S� �#,�yy <br />LECA LOTNO. BLOCK <br />DESC. <br />OWNER <br />' 0 /TDYJ / F�D�z��j['S <br />TENANTNA�I�1E I ' <br />� t/�� C��� f <br />CONTRACTOR <br />CONTR. LICENSE # j n-C � / <br />USE OF BUILqING <br />���� clr!�leX <br />! I PARCEL TAX I.D. # <br />�f <br />I <br />TRACT <br />ADDRESS CI?Y21P <br />C,�C �o �ol� 32Y3 �-1 <br />GON7ACT FOR PERMIT <br />�,�'�'G �� v1 vt <br />ADDRESS <br />�G�v� <br />r <br />CITY2IP <br />PERMIT # <br />IMOSD2-G�J <br />PHONE <br />Gl��c� w.� � �''o � <br />PHONE <br />Zo6 -790 %� 3 <br />PHONE <br />` MEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric YGas Other <br />K DESCRIPTION <br />�n Sf�t �r' ���� �as �r,�a ce <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (serviceibadmop/etcJ <br />Backflow preventer <br />Urinal <br />Drnking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />MECHANICAL <br />TYPE GF FIXTURE OR ITEM <br />-AIC — air handling units <br />For^.ed air syatems <br />Gas H�oing <br />W ater ;ieater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Bailer <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I 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 />� ordinaces governing this rype 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 constructicn or the performance of <br />I construction. That I am authorized by the owner of ihis property to perform the work for which applicatiun is made and I comply with the <br />State Co �rs Law 1.27 RCW and 296.200 WAC. / <br />I . �������'il/l _P'�7l z�a !�s <br />