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PE� rtMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 98201 <br /> 425-257-8810— FPX 425-257-8857 —www.everettwa.org <br /> (,( !' f i J APPLICATIONS ARE ACC�PTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> i� iz6 Pk�N � r-�� �u wa��r ?vs3 � ODOd/� a - � <br /> LEGAL LOT N0. BLOCK TR T OR SUBDIV N/kJ <br /> DESC. l Gt�{ .�,Q �.��I'� �� <br /> OWNER ADDRESS CITY2IP PHONE <br /> �e �<3 �-on1� `tso<< � S�o � � 2�� av� vJ ut�{��o� w/4 �f$o3 ? <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> W� �� E-MAIL <br /> AC D ES CI / I <br /> C.�bblesTon�� cor�Cr r,�i,�s l�� S,�wr � �-�� �-aa�,� � 6��-47�� <br /> CONTR.LICENSE p <br /> USE OFBUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br /> SC� I _Eledric _Gas�Other <br /> I <br /> WORK DESCRIPTION <br /> � �ro�y 1�� � c �•�� <br /> srP�- 0��-a ��6 4-oXL�- Zo �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlYTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toil�t AIC—air handling uni�; <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water hea�er <br /> Kilchen sink S disposal _ Gas(irr,place <br /> Dishwasher Gas range <br /> Clolhes washe r Clolhes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> 6ackflow prcdenler _ Heat pump <br /> Urinal Unit healer <br /> Drinking Pounlain _ Doiler <br /> Floor drein Refrigeration <br /> Grease lrap _ Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhat I have read and examined this application and know lhe same to be true and correcl. Ail provisions o(laws and <br /> ordinaces governing this lype o(work will be complied wiih wheiher specified herein or nol The granling of a permit does not presume <br /> to give aulhority to violale or cancel the provision of any olher stale or local law regulating conslrucGon or the pertormance of <br /> conslruclion.That I am authorized by the owner of this property to pedorm the work for which application is made and 1 comply with the <br /> Slale Contraclors Law 18.27 RCW and 296.200 WAC. <br /> i�—�'� ��-_ - 61�l o� <br /> Signature o(OwnedCo lra lodAulhonzed Agenl Dale <br /> ��z <br />