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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEI', EVERETT, WA 98201 <br /> 425•257-8810—FAX 425-257-8857—www.evereVOAlpRrg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Q _. �'--06 <br /> SITE ADDRESS PARCEL TAX I.D.M P�RMIT M !' <br /> 2500 tt�.vi Tr �E � 98�1 l� !r�';�� _S�r <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. � �I� �0`iO'� t <br /> OWNER ADDRESS CITYIZIP PHONE t�-ZS <br /> YE1�R-SeN �N�i��5�5 Z375 �TI+ AvE SE E„�n�r� 48 205 334- � SYS <br /> TENANT NAME I CONTACT FOR PERMIT pI��H��f PHONE <br /> ��oR.r- oPPor��uN i n�y S c�Tr S c.m�t��-crxZ _5-�5�-�lG�I <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> w II�Go X Cd.v 5771,ul��►o.rv 2 3'�- 5�7Jt fEvE, �i�, 490 Zt� <br /> �ivlV�"'�1`7�' �D �DHon�vs W�; <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> Q�Lri�j _Eledric �Gas_Other t�#� ZD LY�O <br /> — i <br /> WORK DESCRIPTION � ,�JC l S�� <br /> GLNS7Yw�% C�'FrI�ES Fo►y 13°Sl•J�S�+ GJl Ttn � <br /> yP2�u����? �w�.piti� , <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FIXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> ,� Toi@t _ PJC—air henC�g units <br /> —athtub Forced air systems <br /> � i avatory(�vash basin) _ Gas piping <br /> Shower t ater heater <br /> = hitchen sink C disposal _ Gas fireplace <br /> a ishwasher Gas range <br /> Clothes washer Clothes dryer <br /> i aundry tray _ aenge hood <br /> Sink(service/bar/mopletc.) Exhaust fen <br /> —acMlow preventer _ eeat pump <br /> �nnal �nit heater <br /> arinking Founlain _ —oiler <br /> Floor drain o efrigeralion <br /> Grease trap t oodslove <br /> 000f drains Other L�� �i � <br /> Other LKISTIUF7 . ��0�'�P�'`�Gj <br /> _ _ - n„r�,ao2� oUw <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceritify that I have read and examined lhis application and know the seme lo be true and corted. All provisio�s o(laws end <br /> ordinaces goveming this type of work will be complied with whether specified herein or not.The granting ot a pertnit does not presume <br /> to give authority to violale or cancel lhe provision of any ather stata or local law regulaling construction or the performance of <br /> construdion.That I am authorized by lhe owner of lhis propeAy lo perform ihe work for which application is mede end I comply with the <br /> State t to i 18.2T o Ct and 29R.2001 AC. <br /> 7 �Z���(v <br /> Signat �ntractor/ ulhonzed Agent a te � <br /> �� <br />