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P'�RMIT ��PPLICATIG��I <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 - DE81T& G:2EDR CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.X PERMIT M <br /> 2o v� J�� - <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADURESS CITY2IP PMONE <br /> iZ If,ffq;2p SuG Ll V,4lU <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �:ffAS �S'ff+f,eP� ZGYv-ZP3-�/Z/ <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> hQ�RI�JE GDNST RE�x:�� INc Zc�`Z�3���zI <br /> CONTR.LICENSE�I <br /> M�F�u.�q �t.1z Z7�t- rJlc,Kr_2��J ��--m,� 9��0� <br /> USE OF BUILDING � � _, I — HEAT SOURCE CONTRACT PRICE Of WORK <br /> �Jl11ll/�Jl <br /> —��� E�ectric Gas_Other 7 S O , p0 <br /> WORK DESCRIPTION RE�/F12 6/2� �(Y(r�(o� '7D F2avr �2G DF )( <br /> /MER(02 - �P,Q'lnlT a.�Ft I�LOOIt'� dVL�J <br /> PL UMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/barlmop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> � <br /> � CITY OF EVERETT LOCAL SALES SAX CODE IS]105 <br /> i, I hereby ceriti(y that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> iordinaces governing this rype of work will be complied wilh whether specified herein or not. The granting ot a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> ' construction That I am aulhorized by the owner of this property to perform the work for which application is made and i comply with the <br /> i State Con ctors Caw 18.27 and 296.200 WAC. <br /> � � �: _-- <br /> I Si ture o OwnenContracror! onzed Agent te <br /> � <br />