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PI�r�MIT A�RLICATIC.�� <br /> CITY OF EVERFTT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � _�p_OS <br /> 425-257-8810— FAX 4?5-257-8857—w�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX 1.0.# ?ERMIT# <br /> �;��.`7 �'oss v rH �Ue 3 00 0 .n ,���L�' / <br /> LEGAL LOiNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CIN21P PHONE <br /> U� r� FUc .Hs / � � 7 KDSs �7h' ��e �(/ere�f- �f,�S- 5'�8- �G3� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR 5P�11� i)1 L�Jl If yS ADDRESS� .7D Q y �lr�lUP S��N��'��� ��Q���'�I�� <br />�•,-...,' I CONTR.LICENSE# � <br /> s. ,, SP7� l� �ef3L1 �/i50 <br /> USE OF BUILDING HEAT SOURCE C9 NTRACT PRICE OF WORK <br /> _Electric _Gas_Other �! 1O �U n � <br /> �ES RIPTION � <br /> ���z��cL ���a�� 2��2@ 32-G�9 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM � N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C=air handling units <br /> Bathtub Fcrced aiC Systems <br /> _ Lavalory(wash basin) _ Gas pipin� <br /> Shoover Water heate�. <br /> Kitchan_sink&disposal i' � Gas fireplace � <br /> _ DishwasRer.� Gas range <br /> Clothes��asher� - Clothes dryer <br /> _ Laundry tray \ � Range hood <br /> � Sink(service/bar/mop/etc. Exhaust fan <br /> = Backflow preventer - Heat pump \ <br /> Urinal � Unil heater � <br /> _ Drinking Pountain ' Boiler <br /> Floor drain Refrigeretion <br /> Grease trap Woodslove <br /> Roof drains Oltier i <br /> Ot(ier <br /> CITY OF[VERETT LOCAL SALES 7AX COD'e 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 /> ordinaces goveming this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to v{olate or cancel the provision of any other slate or local law regulating conslruction or the performance of <br /> construction. That I am authorized by the owner o(this preperty to pedorm the work for which application is made and I comply with the <br /> Slale Contractors Law 18.27 RCIN and 296.200 WAC. <br /> , �G� �1?�.�� �G � 3 v � s- <br /> SignaWre o OwnedContractor/Authorized Agent � Da� <br />