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�. �� <br /> i <br /> PERMI�' �►PPLICATIOt� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, N!A 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS aRE ACCEPTED PROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL iAX I.D.# PERMI7 R <br /> J l S l�or..L' G,e f' � T-, _ ,�%� > <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION p .-_ <br /> DESC. ' <br /> OWNER �rV/� / .i :-�- C�;�(C;� ADDRESS I CITYlZIP PHONE <br /> .3�v <br /> f..=Al�[.E C'UU.��,�y L�e�NST 'OZ-� S:�rt' Si /��ArzvSe..✓c�.e'- bs3 � �6'� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> E•MAIL <br /> A �i.7/iJSU/.l �L/11�r' I I <br /> � •vt. 2933U /L�ln� ,C�,.�,t.rv.v 36�0 <br /> CONTR.LICENSEp fJ.✓L il:e" p pZL� �L 3 7��` <br /> .�:3��N paF Z7 LyL_ � <br /> USE OF BUILDING HEAT SOURCE CONTFlACT PRICE OF WORK <br /> ,S �� _Elactric _Gas_Olher � z-�;CC' <br /> WORK DESCRIPTION <br /> //r'S7'A-L c. ��/LE S/�.�/niCLC'7Z.S ii•� NL��v S F.2 <br /> PLUMBING MErHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> 7oilet A/C—air handling unils <br /> Balhlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower W ater heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> - Waler healer Range hood <br /> Sink(service/bar/mop/elc.) _ Exhaust fan <br /> Backllow preventer _ Heat pump <br /> � _ Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Re(rigera�ion <br /> Grease trap _ Wootlstove <br /> Rool drains Olher <br /> Other <br /> — � S .�rn../Lu'�l' K'C?�i�s <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby caritily that I have read and examined this application and know the same to be Irue and wrrecL All provisions of laws and <br /> ordinaces governing this type ol work will be complied with whether specified herein or not.The granting ot a permit does nol presume <br /> to give authoriry to violate or cancel Ihe provision of any other state or local law regulating constmction or Ihe peAormance of <br /> I cons;ruction.That I am authonzed by lhe owner of ihis property lo pertorm the work lor which applica�ion is made and I compty with the <br /> S�te Conl�ctors Law 1$2�RCW and 296.2D0 WAC. <br /> ��Sig wre ot 0�er/ o r tor/Author¢ed Agent Date <br /> �l� <br /> � <br />