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P�r2MIT APPLICATI��� <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />7510 tilC�l#l►}r(D D2- <br />LOT NO. <br />Z �- <br />VNA12lC CAf.Uf�T <br />BLOCK <br />IPARCEL TAX I.D. # <br />�� 3R 4o aoo ozzoo <br />TRACT <br />�7510 �ivt-fu�� DR- ��r�T U� <br />TENANT NAME CONTACT FOR PERMIT <br />� � -���— DAUi'Z P'�t��2St���( <br />CON7RACTOR QV�x/ �� f�GADDRESS CITY2IP <br />� � I�X ( 2 <br />G`( � izvf�(q'� <br />CONTR. LICENSE 71 <br />USE OF BUILDING <br />HEATSOURCE <br />_ Electric _ Gao _ _ Olher <br />c zsq-7ZSp <br />PHONE <br />zsy-7zso <br />PHONE <br />zSY( � 7 ZSU <br />CONTRACT PRICE OF WORK <br />WORKDESCRIPTION Cp�-�-R�tpK UF /� ZZ�XZ�(� Woc�� r�4Mr G�1� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry Vay <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIICTURE OR ITEM <br />A/C - air handlfng units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />Boiler <br />RefrigereQon <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceriti(y that I have read and examined this application and know the same lo be lrue and wRect. All provislons of laws and <br />ordinaces goveming this type of work wili be complied with whether specified herein or not. The grantlng of a permit does not presume <br />to give authority to violate or cancei lhe provision of any olher state or Iocal law regulating construction or the pertormance of <br />construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />3-ff3�OS <br />