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.� <br /> � PEr21VIIT APP�I�A.T�O��I --- - � I, <br /> �ITY OF EVERETT PERMIT SERVICES �.� i <br /> 3200 C�DAR S-fREET, EVERETf, WA 98201 � ` Jr'L <br /> 425-257-8310- FAX 425-257-8857-w�r.v�.everettwa.org �,l) 3_ � �S I <br /> APPLICATIONS ARE ACCEPTED FROA7 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEP fEC <br /> SITE AD�RESS/ ' / � PARCEL TAX I.D.iF I PERMIT# <br /> ��� `� y�v�c� /J2 ;�c� "6�/3�3�AFS�L.� i L "_�.�_� <br /> LEGA LOT N0. BLOCK TRACT <br /> oesc. � z��_-oi`,=o� �lv '�� �GJ���` i3 ��Jr��%d/✓ ,�' �C �J,tl. <br /> OWNER, J J ADDRESS �l"GIP PH fiE ` r <br /> / �"GN�1�:� � T7/,P�li �b /.5 T�f� .5c7� /JL�/Ac.4 �On%% (G.�G J�i/i- Y i�/3 <br /> TENANT NAME CONTAGT FOR PERMIT PHONE <br /> CONTRACTUR � ADDRESS , . CITY2IP r ^ fHONE <br /> ^� � �T" c�c'�C [I!//y'4 G�/ <br /> ,�.,4c'/C��� c�.c/S;�NG Y O/S �C � f� `/ ���'���//3 <br /> CONTR.LICENSE#�LU���L_n�/ ��� <br /> / C-� <br /> l'SE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � � Electric Gas Other � `J <br /> <.�.,vG[���,�y.ccs• -- � — /I�(c�.� <br /> , <br /> WORK DESCRIPTION <br /> �^ �' C�� �,c/CGr <br /> /✓��'7J l�;z.� �`=Cr.�;E� ��;,��c c�' ,•�-�,�y <br /> �7�/r22 <br /> PLUMBING MECHANICAL ' <br /> NO. IYPE OF FIXTJRE OR ITEM N0. TYPE UF PIXTURE OR ITEM <br /> � Toilet PJC—air handling units <br /> � Bathtub / Forced�ir systems <br /> SG Lavatory(wash basinJ 3 Gas piping <br /> Shower / Waterheater <br /> � Ki;chen sink&disposal / Gas fireplace <br /> � �ishwasher _[_ Gas range <br /> � Clothes washer / Clothes dryer <br /> _ Laundry tray / Range hcod <br /> Sink(service!har/mop/etc.) � Exhaust fan <br /> Backflow preventer Heatpump <br /> � Urinal Unit heater <br /> Drinkirg Fountain Boiler <br /> 7 � Floor drain � Refrigeration <br /> � � Grease trap Wocdstove <br /> I _ Rooi drains _ Other <br /> � _ Other <br /> I <br /> � <br /> I <br /> ' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> II hereby ceritity thet I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> i ordinaces governin� this type of work will be complied with�vhether apecified herein or not.The granting of a permit does not presume <br /> � to give auLhority to violate o�^.ancel the provision of any other state or local law regulating construction or the performance of <br /> ' construr.tinn.T� t I am authorized by the owner of this property to perform the work for�vhich application is made and I comply with lhe <br /> � Slate Contractors aw 18.27 RCW and 296200 WAC. <br /> I / � <br /> ' •� C � .E�� � -b`1-os'� <br /> I3ignature of Owner/ContractonAu[honzed Agent Date <br /> i � �1 <br /> — - �/�l i� 7-� `� <br /> —� <br /> F i�„vq�.;:_,+ ��.*'..�"9µ'"''"",�'M""'�. -,� "4y. . —,�i�M, ,...,�. . _ — -- <br /> �� r ' <br />..�t"�' "�'�:,'+�n.. � ^s.k'�+w:,�"'r.. <br /> _ �;. <br />