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PEKIl�!!IT APPLIC�Ti�N <br /> CITY OF E`✓ERETT PERMIT SERVICES <br /> 3200 CEDAR STREE'f, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org -, <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��=CJ% :5 <br /> PARCEL TAX I.D.# PEF�7'T# <br /> SITE P�^RESS � U U I `���^ � <br /> 31 �oi•,�3a�o� P.v� u�:�l'� "10 7 I I ooC <br /> BLOCK TRACT�� � � ' �� � � <br /> LEGAL LOT NO. ��I � , � <br /> DESC. � 1 d_� „ � i � �� ` 'JA.��; ' _ i .J,.. <br /> ADDRESS CITYIZIP � PHONE <br /> OWNER ��.�clU,Zw c_�•.�trcc..cfS tc� �.� ?,o. 1��'13� F�ecrt 9,`.`Zi3 y2S. P.7o � 71Y7 <br /> TENANTNAME <br /> I CONTACT FOR PERMIT PHONE <br /> ADDRESS CITYIZIP PHO��r_ a7o � 7a`l7 <br /> ^.ONTRACTOR �f..;�S LLC L�!X oZCy� E��t'vd 5�112 �/2S � �. <br /> ,`�.X�Unt� V�C._7 C�:\tfn I�G. <br /> CON'fR.UCENSE# L �'S I K Q �Jl'�/ I <br /> �� ���- I C NTRACT PRICE OF WORK <br /> USE OF BUILDING I HEAT SOURCE <br /> 5 � � _Electric �Gas_Othrr � <br /> � a�s', pOG <br /> WORKDESCRIPTION i` � �IQinc�.e:� S �^s�� �A�`�� �`/ I?eS�cdencC <br /> vu. icl �S' <br /> yJCc�'�l G �� �/-' <br /> — PLUMBING MECHaNiCAL <br /> NQ, TYPE OF FIXTURE OR ITEM <br /> NO. TYPE OF FIXTURE OR ITEM <br /> - A/C-air handling units <br /> 1_ Toilet I Forced air systems <br /> � Balhlub � Gas piping <br /> Y Lavatory(wash basin) �_ Water healer <br /> I Shower � Gas fireplace <br /> I Kilchen sink&disposal �_ Gas range <br /> �_ Dishwasher ( Clothes dryer <br /> I Clothes washer ( Range hood <br /> Laundry lray � Exhaust(an <br /> Sink(service�bar/mop/etc.) �� Heat pump <br /> Backtlow Preventer Unit heater <br /> Urinal Boiler <br /> Drinkiny Fountain Refrigeralion <br /> Floor drain Woodslove <br /> Grease frap i Other �� <br /> _ Roof dralns ,1 �I <br /> = Other I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereCy centify that I have read and examined this application and know lhe same to be lrue ar.d correcl. All provisions of laws and <br /> ordinaces c�rnerning this type of work will be complied with whelher speci(ied herein or noL The granting of a permil does not presume <br /> to gi�e authority to violale or cancel the provision of any other slate or local law regulating consWction or the performance of <br /> conslruclion.That I arp authorized by lhe owner af lhis property lo periorm the work tor which applicalion is made and I comply wilh the <br /> Slate Contractors L9W, .27 RCW�ud-29B:Z60 WAC. <br /> � � �� <br /> _,,�� /��� ��� �� � <br /> Dale i Z <br /> Signalu�e of wnedContractodAulhonzed Agent <br /> �_ j'�i! '�'=^ ��� <br />