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� ' r �;_� <br /> `-�Ji��- . <br /> PERMIT APPLICATION � "= J L�'��/� <br /> CITY OF EVERETT PERMIT SERVICES n�� 12 ?008 � <br /> , n �p 3200 CEDAR STREET, EVERETT, WA 98201 <br /> �l/,� 425-257-8810—FAX 425-257-8857—www.everettwa.org^�� Y GF �, .... <br /> �'/ ` ^;in�'N�,,f�RE7'T...... <br /> �� n APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM S=Z�r,;r• ; <br /> � Il <br /> � �VY SITE ADDRESS PARCEL TAX I.D.X PE MI A <br /> �`` I' �4/� �', ;.c SF ��z� / .29a7 zoov yo k-��z� I ��1� <br /> LEGAI LOTNO. BLOCK 7RACT <br /> ��L� DESC. <br /> ONMER ADDRE55 CfTYILP PHONE <br /> �C� 1��� 6.�.�-l� ��,�� �;,ti� s-/ �t�z,e// u/a ���z��i ��zs-zs5�-.53 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> _� c�l/r?' �ctilG� ��n �,�GS�t- /— -�U—�l��" `5-58`6 <br /> CONTRACTOR • � /� ADDRE55 � ! �CITY P PHONE <br /> �c�Asr+����rrr� ���r� — j>5�, � l�c�c ,��7r — <br /> �i{�it'f��ZS �./'L`��17 �7 s��S'70/Jl <br /> CONTR.LICENSE It <br /> CC�RSHIF�`iyvUr `��� ''y <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �.!� '! Z< Oa <br /> Electric Gas�Other � �- <br /> WORK DESCRIPTION 1 ./ / � <br /> �f. hcii�o- v7-�-7 j ��+`-• �(:1i7"� /�' �iZ� � <br /> ,�7� <br /> PLUMBING MECHANI6AL ,� F„��" <br /> � . <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI�JR�CR IT-U�I <br /> r <br /> Toilet A/C-air handling units `>= u� <br /> Bathtub Farced air syslems ti' <br /> Lavatory(wash basin) � Gas pipinq {'v' �,�,', <br /> _ Shower Water heater ,^-�n <br /> Kitchen sink 8 disposal Gas fireplace ,�, <br /> _ Dishwasher Gas range �' <br /> _ Clothes washer Clothes dryer � � <br /> Laundry lray Range hood �ri <br /> _ Sink(servicelbadmopletc) Exhaust fan .";� �`f.S � <br /> _ BackOow preventer _ Heat pump -�'Q.`� o <br /> c dc o:'•' <br /> _ Urinai Unit heater �,� <br /> _ Drinking Fountain Boiler —'o�� <br /> Floor drain Re(rigeralion �•�s3 <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS J105 <br /> I hereby ceritify thal I have read and examined this apptication and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing ihis type of work will be wmplied with whether specified herein or not.The granting of a permit dces not presume <br /> to give authority to violate or cancel lhe provision of any other state or local law regulating construdion or the performance of <br /> constniction. That I am authorized by lhe owner of this property to perfortn the vrork for which applicatlon is made and I comply with the <br /> State Conlractors Law 16.27 RCW and 296200 WAC. <br /> � t�''�— ( { ).L`���l,L . � ����v <br /> Signature ot wned ontract onzed�Agent� Date ,. <br /> �----" <br />