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c <br /> PtRMIT APPLICATIC�N ���� a''� <br /> CITY OF EVERETT PERMIT SERVICES � � <br /> 3200 CEDF,R 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 -I `- 9`-�� <br /> SITE ADDRESS /J PARCEL TAX I.D.# pE IT# �y <br /> ll3/5 �. �BBEKSo� YR�v,� 00`�79l.0�00550! '� --5(000 n"��5 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. 5� IBaER30�.1 PAKK <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> 3oe �,c%rsro�t 19/i /07�"Sr SE �vrRe�r.lJ9 98209 '/z5.338.3893 <br /> TENANT NAA7E CONTACT FOR PERMIT PHONE <br /> �//A' ; •� _ <br /> ' .. <br /> CONTRACTOR DDRESS CITYIZIP PHONE <br /> CONTR�LICEN�h�r���' ' ' ' � � . • <br /> . , ' / <br /> USE OF BUILDING HEAT SOURCE CO`NTRACT PRICE OF WORK <br /> /[E3iQEUGE � !���RY _[ledric �Gas X Other<�ypi��� y 7Jr����•� <br /> WORK DESCRIPTION � / � <br /> DEMO �INo REMOYE �'x�sr�.lG NOvsE � Two 'f'ouNDAno� WAlis /n hEMA/�,/ (�atfN�C�ES��� <br /> �pnrsrxu4r l�Ew RES7bE�J4E l.��An^cHsn �'jA[AGE. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel 4�.' A/C-air handling unils <br /> . _� Balhlub i%` Forced air systems <br /> '...L'J Lavatory(wash basin) ��'; � �Q±' Gas piping <br /> � ! Shower /� / Water healer <br /> � Kitchen sink&disposal � Gas fireplace <br /> � Dishwasher 2 Gas range <br /> 2 Clothes washer �—� Clothes dryer <br /> ,?" Waler heater 'v Range hood <br /> 7 Sink(service/badmop/etc.) � Exhausl fan �'//,i/ <br /> Backflow prevenler Heat pump <br /> Urinal Unil healer <br /> I Drinking Fountain _ Boiler <br /> p _ Floor drain _ Re(rigeralion <br /> I _ Grease trap Woodslove <br /> Roo(drains � Olher�AO�AN� f,9/ <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know ihe same to be true and correcL All provisions of laws and <br /> ordinaces�overning lhis type of�vork will be complied wilh whether speci(ied herein or noL The granling of a permil does nol presume <br /> to givc authoriry to violale or cancel the provision of any other state or local 12w rec�ulating construction or ihe performance of <br /> conslruction.Thal I am aulhorized by lhe owner of lhis properly to perform Ihe work lor which applicalion is made and I comply wilh ihe <br /> Slale Contractor$Law 6.27 RCW and 296.200 WAC. <br /> , ,�,,,� 2�3�07 <br /> SignaWr�of 4ne I onlractodAuthorized Agenl Dale �/� <br /> - /�--/-\i------ - �/�-f---- <br />