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' ! <br /> �ERMIT APPLICATIuN <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 9' �. a —�(� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT S <br /> /�Z-GRAN� � �4-753 /l 0.5� OO ' <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. �_Ed� p IJ,• 31' �Y � A /-f���,�5 �QS% .DDiTiotil. l�oL. 4, Pi4E,FS s►�b�I�CN�` <br /> OWNER A DRESS C�TY21P PH(�� z��•�j pyS <br /> st� <br /> I-�A�eo�� S S1Ef�c'L /432-C''2AtiD f�� ���R�7T, 98zn1-�bo� — <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> NoN� ��6� E-MAIL <br /> CONTR.LICENSE M <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S/A1 C��a /^�I i77/,(�/ �E�(d EIU$� —Electric X Gas_Other ��� d O0 <br /> WORK DESCRIPTION <br /> S�CoN � S�hY �DD/!�O� ldOo <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet _ A/C–air handling units <br /> Balhtub _ Forced air systems <br /> % Lavatory(wash basin) _ Gas piping ' <br /> � Shower — <br /> Water heater � <br /> Kilchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clothes dryer <br /> Water heater Range hood <br /> Sink(servicelbar/mop/etc.) � Exhausl fan <br /> Backflow preventer _ Heal pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain ,_ Boiler <br /> Floor drain _ Refrigeration <br /> Grease trap _, W�dstove <br /> Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I hereby certify that I have read and examined this applicalion and know the same ta be true and corred. All provisions o1 laws and <br /> ordinances goveming ihis type oi woric will be complied with whether specified herein or not.The granting o(a permil does not presume <br /> to give authority lo violate or cancel the provision ot any other stete or local law regulating construdion or the periormance of <br /> construction.That I am authorized by the owner of this property to periorm the work for which applicatlon is made and I comply with the <br /> SIa1e Conir ors La�.27 R �a�96.200 WAC. <br /> �/'CG' Date I ( � / <br /> Signa re ot Ow r Co ractor ulh nzed Agent v <br />