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�rRMIT APPLI�CATI�IN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E'JERETT, WA 98201 <br /> 425-257-8810— FAX 425;?57-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / Z--�-?J � <br /> SITE ADD SS �i2'F'� PARCEL TAX I.D.# PERMIT# <br /> j�����,- �� ����3 ;� a��a-�,�- <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION 8 <br /> DESC. <br /> �'j��4 g s./� _/`��� ��lP�Da / 3Z6RES� l�[� CITY2IP PHONE <br /> GClI 4'- <br /> � l u�C 9 � <br /> TENANTNAME / CONTAC1TFO,/R� �PERMIT �s�g,_ �.yg-.� <br /> GL ��.Lr'l C�/�� �SO"Ii\ E-MAILSI:C"�'�Ci[/Qx.'� <br /> ( <br /> xU.��/�CC'-7�= ��' /�z�G� Pll[>� Cl sz�-�� �zs srx�S78� <br /> C�IONTR.LICENSE p ��¢ �� '���"� <br /> G�I�f{l � <br /> USE OFBUILDING EAT SOURCE CONTRACT PRICE OF WORK <br /> ��i�G2�'l�«- ectric Gas_Other �ZZI ��� <br /> WORK DESCRIPTION <br /> 7'u�o 2:3' � �� ��c� ; ,��u-�c�z�//qo�l �-�����, <br /> ,���'-�v�i�� 6��`��.�-r� <br /> PLUMBING MECHANICAL <br /> NO. TYFe OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C-air handlin�unils <br /> Bathlub Forced air syslems <br /> Lavalory(wash basin) � Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas freplaco <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust(an <br /> Backflow preventer Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiier <br /> Floor drain Refrigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> . <br /> Olher __ b ��'�— <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerili(y Ihat I have read and examined lhis appiication and know the same to be true and correcL All provisions of laws and <br /> erdinaces governing lhis rype of work will be complied wifh whether specified herein or not.The granting of a permit does not presume <br /> lo c�ive authoriry to violate or cancel the provision nf any olher state or local law regulating conslruction or the pedormance of <br /> conslruclion.That I am aulhorized by lhe owner o(this property to perform lhe work for which application is made and I comply with the <br /> Slale Conlraclors Law 1827 RCW and 29�.200 WAC. <br /> :���;�/f/e����s�� /2 -�-O�g. <br /> SignaWre oYOwnedConlractor/Aulhorized A9ent Dale <br />