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P ,�RMIT APPLICATIC .J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /'� -� J <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org � �(/,`J��� <br /> �� f� A?PLICATIONS ARE ACCEPYED FROM 8 AM TO 4 PM !i <br /> SITE ADDRESS _ PARCEL TAX I.D.A I PERJ�IT A_� `�I <br /> :� �►�i�h��� p�,+h �� �v <br /> LE LOTNO.� n BLOCK TRACT <br /> DESC. b <br /> OWNER �. �� ///�ADDRESS _� ��E�D��P PHONE � �yl� <br /> �, ��GtiUcr ��� <br /> TENANT NAME CONTACT FOR PERMIT pHONE <br /> I �lp.�"�ela. � h�J �F2S-?s�/ - !` <br /> CONTRIICTOR �,� /JmQ-�Q DDRE55 CI1Y21P �P�ON�� ,,/,7O <br /> r <br /> CON7R.L10EN��D,tL'J�'�`a'� "�� / �*' ��IQ� G�-C�.JCW�/'�7 N/A- <br /> /� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric ✓Gas_OMer <br /> WORK D SC� RIPT�ON � <br /> �[l;b���X� �O� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE Of flXTURE OR ITEM <br /> Toilet NC-air handling units <br /> �-- Forced eir systems <br /> � Bathtub Gas piping <br /> � Lavatory(wash basin) � VJater heater <br /> � Shower Gas fire lace <br /> � Kitchen sink 8 disposal -L p <br /> Dishwesher � Gesrange <br /> � Clothes wesfier 1 Clolhes dryer <br /> Leundry lrey �t- Range hood <br /> � Sink(service/bar/mopletc.) Exheustfan <br /> BeckBow preventer _ Heal pump <br /> UnN heeter <br /> �- 1��f18� �� 60��8f <br /> _ Drinking Fountain � Refrigeration <br /> _ Floordrain Woodstove <br /> _ Grease trep Other <br /> Roof drains — <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J106 <br /> I hereby ceritiry that I havc read and exemined this epplicalion end k�ow the seme to be true and cortacl. All provisions of Iaws and <br /> ordinaces goveming this lype of wark will be complied with whether spacified herefn or not.The grenting of e permft does not presume <br /> to give aulhority to vlolele or cencel lhe provision ot any other stele or local law regulatlng consirudion ot ihe pei.ortnance ol <br /> construction.Thet I am euthorized by ihe owner o1 this property to peAortn the work for which epplication is made and I comply with 1he <br /> Stale ConVactors Law 18.27 RCW and 296.200 WAC. , <br /> 7/���j� � <br /> Signature n wnerl ontrador/Authorized Agent ete <br /> ` I� <br /> , � ; \ <br /> � <br />