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FERMIT APPLICATION \AAeevn <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, 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 / PARCEL TAX I.D. # PERMIT # <br />1 0�! ��/1tv2 oo4P0%&00000-700 7I �Z— <br />LEGA LOT NO. BLOCK TRACT OR SUBDIVISION # <br />DESC. 060 D-00 A L.4 ekS MaoF- <br />OWNER ADDRESS CITYIZIP PHONEAZ-9-7S4'2CiZ <br />S-rmm �ot{A! {.,AND6yc-kk Cansf LLB �315 5 r2J�+�E 2� Ka�(1eLt 9�®12 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />61 <br />pj1A 5TEvE ^r SE.QIL-A-n—Hj! k®IlISAI•C� <br />o nu <br />CONTR. LICENSE # .S T6VE,Tt-q 59 KGL <br />USE OF BUILDING <br />M M71- <br />HEAT SOURCE I CONTRACT PRICt Ut'VVUKn <br />Electric Gas _ Other <br />WORK DESCRIPTION <br />jox,SO <br />,_ neJ-Ifl,nnJv P%OSi[IFtACe <br />V FLU BING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C — airhandlingunits <br />Bathtub <br />Lavatory (wash basin) <br />I <br />q— <br />Forced air systems <br />Gas piping <br />Water heater <br />�-Ii <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />j_ <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Water heater <br />Sink (service/bar/mop/etc.) <br />_ 4 <br />Exhaust fan <br />_ <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />— <br />— <br />— <br />— <br />— <br />_ <br />— <br />Heat pump <br />Unit heater <br />Boller <br />Refrigeration <br />Woodstove <br />Other. <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX 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 />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 stale or local law regulating construction or the performance of <br />construction. at I am ay8lprizaa byhe owner of this property to perform the work for which application Is made and I comply with the <br />State Contr c rs Law 1 2 R Wad 296.200 WAC. <br />I() <br />