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\ <br /> P'ERMIT APPLIC�ATIOYV �� 4+ <br /> CITY OF EVERE7T PERMIT SERVICES � ��' / <br /> 3200 CEDAR STREET, EVERETT, W�, 98201 C L�� I`� <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org J 5�l � <br /> � � <br /> j/�� APPLICATIONS ARE ACCEPTED FROM 8�4M TO 4 PM � � �n -/I_o� <br /> SITE ADDRESS PARCEL TAX I.D.tl PF�tMIT# <br /> o �U - -- �-- <br /> LEGAL LOTNO. BLOCK TRACT ��)jC./I -C�� I <br /> DESC. Q / � _ <br /> OWNER ADDRESS ITYIZIP PHOhIE ZS 7�S-9i/a� <br /> �lr,��,�i i�/re�l T y Lc 2c�c� - ��'� .� �i(/�S� 280 6t�n��loen ;�g��rv <br /> TEN NT NAME �CONT�CT FOR PERMIT PHONE <br /> l�� ' L(J -�IU �SUI{ �{/1r A/J/�/n1.S�`nJ/1/1Cr-/tTFG7S C�ZS� zSZ�Z/S.3 <br /> (6L � � I <br /> � W � �f'7� LLCin(f.f/fFUS ZF/2 ('O-L��� �r- �l�f-✓1-Fir .�U� IRZO/ <br /> CONTRACTOR ADDRESS CINIZI'r � PHONE � <br /> /�/at�CS���vE�2 ' Zo�on- �fr/��AvE, lJ.� 5�e 7.�y ' <br /> CONTR.L�I:ENSE# L �n1n�cJon�o, �,,)/�- ��,Zyv �'L.S- �75- g�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> r"��� 1"l�lf(�F�G�II�l/�y _Eleciric �Gas_Other ��/2�t �D I <br /> WORKDESCRIPTION ��,�SryyU�c,J � J,J�) 2S�ySS�t- �LTCCW�'� �R�"`ti�� <br /> � �1�-KI� LD l �iT/ �Z� !!C�L'Nn.'C. �f.��d.�LO��.S. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Laundry lray _ Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventur _ Heat pump <br /> Urinal Unit heatei <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roo(drains Olher <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 correct. All provisions of laws an� I <br /> ordinaces goveming this lype of work will be complied with whether specifed herein or noL The granting of a permit does not presume <br /> to give authoriry to violate or cancel the provision ot any other state or local law regulating construction or the performance of <br /> construction. TI I am authorized by the owner of lhis property to perform the work for which application is made and I comply with the I <br /> State Contr tor aw 1827 C�(J rJtl 296200 WAC. , , <br /> �_ l� � �� � <br /> Signat e dContract u onze gent ate `� <br /> � �r/�i�/ ��n. ,<.,.�1.--�nrt,=��'-r.�— ----- Z <br />