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� P�RMIT APPLICATION <br /> CITY 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 ��� '� <br /> SITE ADDRE S PARCEL TiJC I.D.X I PER T/ <br /> 9/9 Pw-� ✓�- — i oi <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> !llP� Allf9� 19�s h�ew,/f f��- L 1 �'v��ft,uf� 98'�0l <br /> TENANT NAME CONTACT FOR PERMIT PNONE <br /> +�re��/l�� I 8/���J/ran dc� 979-�/96 0 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE N �/� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> , r <br /> � Z 2�r�� �Electric _Gas_Other ��D� <br /> WORK DESCRIPTION I�e���n„ �a �an -�O(' Q�Ze� �/'1 <br /> �� � '�Wu�� •� '. <br /> .�nS'�ci II�S�nKS ncedPd to� 5 • • <br /> S�PP'y �nd drAi� for 5v�� °ra.j��v�! <br /> PLUMBING MECHANICAL . <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIX7URE OR ITEM <br /> Toilel _ A/C—air handling unfls � ' <br /> Balhtub Forced air syslems <br /> Lavalory(wash basin) � Gas piping <br /> Shower _ Waterheater <br /> Kitchen sink&disposal _ Gas fireplace <br /> = Dishwasher _ Gas range <br /> Clothes washer _ Clothes dryer <br /> Water heater Range hood <br /> � Sink(service/bar/mopletc.) = Ezhaust tan <br /> Backtlow preventer Heat pump <br /> Urinal _ Unil healer <br /> Drinking Fountain Boiler <br /> � Floor drain = Refrigeralio� <br /> Grease trap Woodstove <br /> Roof drains _ Other <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerility thal I have read and examined this application and know the same to be Uue and cortect. All provisions of laws and <br /> ordinaces goveming this lype of work will be complied with whether specitied herein or not.The granting of a permit does not presume <br /> to give authority lo violate or cancel the provision of any other stale or local law regulaling conslruction or the perfortnance of <br /> ronstruction t I am authorized by the owner of this property lo perform the vrork tor which applicadon is made and I comply with the <br /> Stale C t s Law 18.27 RCW and 296.200 WAC. /�O�O� <br /> SignaWre of C+vnedConlracrorlAuthonzed Agenl ate 1 <br /> /� <br />