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PERMIT APPLICATION <br /> CITY OF EUERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 9 1 <br /> 425-257-8810—FAX 425-257-8857—www.e reVOAlpRrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO �� `O "��I <br /> SITEADDRESS Z�oo HEWITT AVE pARCELTAXI.D.N PERMITA <br /> '6vE1ZE7T wa q��i o0�37� sooqoo � «„��,<<-�33 <br /> LEGA LOT N�� �O�C� TRACT <br /> DESC. G� - � <br /> ONMER ADDRESS CITYIZIP PNONE <br /> �&-f�1r�u �p,t5�, Z375 7�'i 7}t Av� ,5� d�Tl WA `t$ZDS So� <br /> o�o <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �L�LTfI SOUT't'I I SGOTT SG{�6�LEIZ �'S LS5 3I6� <br /> CONTRACTOR �r1�(�Qx ADDRESS CITYILP PMONE <br /> z34 -�r� avE �. q-zs 774 4/� ll <br /> CONTR.LICENSE• �j)I'1ONps wq 980� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Ln�K�t7� Electric �Gas_Other �' � ��d I �� <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> ToiOt A/C-airhan0�gunitsEKl4 �14� <br /> -athtub Forced eir systems QCl'/flNt� <br /> � i avatory(wash basin) Gas piping <br /> Shower t ater heater <br /> h itchen sink C disposal Gas fireplace <br /> aishwasher Gas range <br /> Clothes washer = Clothes dryer <br /> _ i aundry lray oange hood <br /> Sink(service/bar/mop/etc.) �� Exhaust fan <br /> -ackAow preventer eeat pump <br /> � rinal �nit heater <br /> �� arinking Fountain -oiler <br /> Floor drain oefigeration <br /> Greasz trep t oodstove <br /> 000f drams Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <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 th;type of work will be complied v.•ith whether specified herein or not.The granting of a permit d�+es not presume <br /> to give authority to v!�late or cancel the provision of any other state or local law regulating construdion or the perfortnance of <br /> construction.That i am authonzed by the owner of this property to periortn the work for which applicaGon is made and I comply with the <br /> Stat o ct rs i aw 18.2T oCt and 296.200 t AC. <br /> Signa ur O ontractodAuthonzed Agent � � tea � <br /> I - /� <br />