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� <br /> PE�tMIT APPLICpTIGN <br /> CITIr' 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 � _ ��—�j',) <br /> SITE ADDRESS �c� L (�PAR EL TAX I.D.# PERMiT# <br /> 1 .° :.�� Tn�„a/-ry S�rteF , �vPr� � 06���a�C� Cf�� L �) C i�J 1 Q(,' i <br /> LFGAL LOTNO. E�OCK TRACT <br /> DESC. <br /> OWNER ADDRESS CIN121P PHONE Z J� - <br /> lallc��'.`.!� � ��.�/C1�(�r�e.�� � �i`1JC? 5�,.44-C?n�-t'I �11w� T�k�..'1t 5fi �3Y �s33- 38`-i� <br /> TLNANT NAME CONTACT FOR PERMIT PHONE <br /> (�Ic1�rc.c1 .� S�-.'Y� � �4M2S F�'�'L�'1 �Nw �is } ti2j � lcls `J125' <br /> CONTRACTOR Nv� � Welt- �-,M�al�n7 ADDRESS CITYIZIP PHONE <br /> t�oclw 7��' 3�} .�2,¢,.Wn �j2J' Z>SaS.� 'v <br /> CONTft.LICENSE# Z�S y 5 S G S�I <br /> iN�%R i Nw�i F <br /> USE Of BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Mp,,�J F�.,�}�.,��} I ;,Jcti 2h�vy C __Eleclric __Ga;_Other .� � ��� �� � <br /> WORK DESCRIPTION 1 . <br /> .Lni��.\1 rG\�R.� �tul•�C�ns �Yf l.'11'rl�c-HC� C�f''�w.rcS <br /> J <br /> TA —ri.c+K F.I'� 5v��''Yls�l1� � �7t'. (`i."M�1�Pca {- in� }i�.�IFo4 hy L:T',2f) . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C—air handling units <br /> BathWb Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> Backllow prevenler Neat pump <br /> Uri�,al Unil heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigersiion <br /> Grease trap _ 1Noodstove <br /> Roo(drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> I hereby ceritiy lhat I have read and examined this application and Know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this type of work�vill be complied with whether specifed herein or noL The granting of a permi!does not presume <br /> to give authority to violata or cancel the provision of any other stale or local law regulalina censtruction or the periormance of <br /> construction. That I am authorized by lhe owner of this property to perform the work for�Nhich application is made and I compty with lhe <br /> Slate Contrac`ors La 1827 RCW and 296.200 WAc. <br /> 2-7- �7 <br /> Signaiure of� dConh •tor/Aulhorized Agent Date i <br /> �L <br />