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PERMIT APPLICATION <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 <br />SITE ADDRESS <br />PARCEL TAX I.D. X <br />PE IT 4 <br />LEGAL LOT NO. <br />DESC. ' <br />BLOCK <br />' bl" D- <br />TRACT <br />Ey Nvi�ivl, Plr.i- blk 38co •1�-t?x <br />OWNER ADDRESS CITYIZIP PHONE <br />P)Aj&\I t; 5L)6 f t=LLE[,Ie1NI, 19-31 Rainier 6ercthVA SIX (GI�I <br />TENANT NAME dONTACT FOR PERMIT PHONE <br />(;�- krrU1- <br />—I�C��C�ylni <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />M Ltlov'UkU �lW� � i cn zt1t, �etr is n <br />CONTR. LICENSE A <br />�� t - �f.e� �� •tea,-1 -tr size I �e� � �� iF3A <br />USE OF BUILDING L. 8 e HEAT SOURCE CONTRACT PRICE OF WORK <br />_Electric -X Gas _ Olhel <br />ORK DE CRIPTION <br />j 4A U� r ' w 1 <br />o)'E>>.-t.,�a�t�.L�(,�C-( bq.u.�t-n- <br />�yw.i,uLnxt)L �Y.Lk�-�•1 lr�ul.�ltiyi (�. <br />l.yl.�1 �1.e11�1' ft,tLA.LCi,li11 tc IBC �t,5,a-t�Y�oJ !�,L�ay.. � 1�::'rivcc-+^�,v� <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE GR ITEM <br />Toilet <br />Bathtub <br />f <br />A/C air handling units ,L <br />Forced air systems—rL2LL �%Ih61 yIV �L <br />Lavatory (wash basin) <br />_ <br />Gas piping J <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />_ <br />Gas firep.�,ce <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Range hood <br />Exhaust fan <br />_ <br />BackBow provenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease '•ap <br />Woodstove <br />_ <br />Roof drains <br />Othei <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other slate or local law regulating construction or the performance of <br />construction. That t am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Sla)o Conlractprs Law 18.27 RCW and 296.200 WAC. <br />I(z <br />