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PERMIT 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 � �/ U V���� <br /> RE�A RESS PARCEL TAX I.D.# P MI # <br /> ILL`{ Ra*1D AV� �u��`l 2vSooHo-a 's pc • Tu26dU U' - / <br /> AL LOT NO. BLOCK TRACT OR SUBOIVISION p <br /> OESC. �I � �i�Z$ Z� ZY� LNVFW� R�J(_l LPrVIOo�-6$ <br /> OWNER ADORESS CITY2IP PHONE <br /> �oN aN� u"b LE���I 13'',9 �1v�r-i�-[i,v B�vv Evc`t'^ET� 9bZG3 HL� LSz, y37y <br /> TENANT NAME CONTACi F PE IT PHONE •3�� ��/) 3��y/ <br /> � Y <br /> � �D✓� �A"�U��� E•MAIL <br /> CONTRACTOR AODRES CITY/21P PH NE <br /> CONTR.LICENSE p I�> <br /> USE OF BUILDING HEAT SOUflCE I CONTRACT PRICE OF WORK <br /> Q^5 iL'�EN(,r I _Eleciric �Gas_Olher <br /> WORk DESCRIPTION � l�� <br /> �E�v�l.t�\T10�I AnID U[�W �SID6rlCr CO:�S7Hi�TIO+� � �J <br /> ��y j <br /> ��/L xZz <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 3 Toilet �� \ A/C—air handling unils <br /> 'L Batlitub 1 j l Forcedairsyslems � <br /> � Lavalory(wash basin)� � t\ � Gas piping <br /> _�_ Shower i� �_ Walcr healer I <br /> � Kitchen sink 8 disposal � � Gas fireplace <br /> � Dishwasher � � Gas range . <br /> _L Clothes washer� � Clothes dryer 1 <br /> Waler heater Range hoad <br /> _L Sink(servicelbar/mop/elc.) � Exhaust fan � i � � � �� <br /> _ Backllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinkin�Founlain Boiler <br /> Floor drain � Relrigeration <br /> Grease trap _ Woodslove <br /> Roaf drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hcreby ceritity thal I have r and examined this application and know ihe same�o be ime and correcL AII provisions of laws and <br /> ordi ces go rning his typ i work�vill be complied wiUi whether specified herein or not The granting of a permit does not presume <br /> to_q iv author ty to v late o c nc the provision of any other state or local la�v regulating cnnstructlon or�he performance of <br /> colfsir iction hal f i auth r�ze the owner of this properry to pedorm ihe work for which application is�nade and I comply with Ihe <br /> St�te onts ors La 18.2 nd 296.200 WAC. <br /> �✓ i <br /> Sig a ure of O� r/Co t actor uthorized Ac�ent ate <br /> � j <br />