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i <br /> PERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32!,� CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 4�5-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G� �a6 -06 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT t{ <br /> 3�zi �v��< ►U� � ����s-�y �os�� ��� C a� - � <br /> LEGA LOT NO. BLOCK TRACT �) ,/ <br /> DESC. ���l I l Z �� s�h�t � GU 3 Fri!/t� s � S'�' A��I T�O F�r%-t Yt <br /> OWNER ADDRESS CITYIZIP PHON[ yz� �sr� <br /> �,co� {� , �1�c Ue ( ( f3 S 33 E<s+✓�-�� /� � Fvc:z� w A F�'� sszs <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I �CoS Yh �-kl� l� �fZ-5 �S� SSZf�' <br /> CONTRACTOR C. I � /G`u`� r ADDRESS CITY2IP PHONE <br /> r / <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE 6GN�RIIeT PRICE OF WORK <br /> � �y,� �� �Gi„�i�y �QS� ���.�L _Electric �as_Olhcr �(7 90��l� <br /> WORKDESCRIPTION �e��L� C� ��y ��.� � � �.bc`� � �2 ���cC_ ��uc��i�f, � viYyY�- % <br /> ��� �� � f Ll�civi�t��p I'r(?allr �(- � i�� �erjw- C/oSe-�S {�n�wi� � ,ntkll-�to� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Z Toiiet A/C—air handling units <br /> Z Balhlub � Porced air systems <br /> �� Lavalory(wash basin) � Gas piping <br /> � Shower ,� Waler heater <br /> � Kilchen sink&disposal �, Gas firepiace <br /> � Dishwasher Gas range <br /> Clolhes washer � Clothes dryer <br /> _L Waler heater Range hood <br /> � _ Sink(scrvice/bar/mop/etc.) � Exhaust fan <br /> Backllow prevenler _ Heal pump <br /> Urinai Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roo(drains Other <br /> Other <br /> — i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceriti(y that I have read and examined lhis application and know lhe same to be true and correcL All provisions of laws and <br /> ordinaces governing lhis lype of work wili be complied wilh whether specified herein or noL The grantinc�of a permil does not presume <br /> to give aulhoriry lo violate or cancel the provision o(any olher stale or Iocal law regulaling conslruclion or the per(ormance of <br /> construclion.Thal I am authorized by Ihu owner of this property lo perform the work for which application is made and I comply wilh the <br /> Stale Contraclors Law 18.27 RCW and 29G200 WAC. <br /> ', r�� I L �1�u=�(' �a /7�/U C <br /> Signalurr,of OwnedContracton:luthonzed Agenl Date (h <br /> � <br />