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PL.�ZMIT APPLICATIG. � <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 ADDRESS PARCEL TAX I.D.p PERMIT# <br /> 1 0 � � , UU1 �0 0 �-D.;�- <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Yh:.r �o-•,-• Kc.s-1-�t `���...n�c�� ������ �lZf - �17.2 • B �-82. <br /> �y.�� G rt,nc1 �vC �4'� 1t\\ <br /> TENANTNAME - CONTACTFORPERMIT PHONE <br /> E-MAIL <br /> C RA T 7ZI <br /> �4�w�.t� �-�Zt�'� "� <br /> CONTR.LICENSE R � GU i$ vJ �N<a.t�o..J lr�(t-�' �.' �l� �`' �G o ' U�(n�j <br /> KA�.�, EH,� nC�(� PD S�c� •+•:�� SXZSU <br /> US� OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleciric Gas O�her � (l.��C� — <br /> WORK DESCRIPTION <br /> 2C �'��i_�� c_ S� > �., c w�. \�: �.,{ �tc�' <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Halhtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink& disposal Gas tireplace <br /> Dishwasher � Gasrange <br /> Glolhes washer Clothes dryer <br /> � Water hea�er � _ Range hood <br /> Sink (service/badmop/elc) Ezhaust fan , <br /> Backtlow prevenler Heat pump <br /> Urinal Unil hea�er <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration � <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> I hereby certily thal I have iead and examined this appiication and know the same to be true and corred. All provisions of laws and <br /> ordinances governing this type of woik will be complied wilh whether specified herein or noL The granting of a permit does not presume <br /> to give authorily to violate or cancel ihe prowsion of any other state or local law regulating construction or the peAormance oi <br /> construction. Thal t am authorized by ihe owner of ihis property to pertorm ihe work tor which application is made and I comply with the <br /> State CoMractors Law 1827 RCW and 296200 W�C. <br /> N� � [. � . ZZ. <br /> Signature o(Owner/Con�ract Authorized Agen! Dale <br /> � <br />