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�- PERIVIIT 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 ����-� �Ak S �1� PARCEL TAX I.D.�F PERMIT#� <br /> 9/1 svs ois �^ p�S o I - oti �! <br /> LEGAL LOT NO. BLOCK TRACT OR SUBOIVISION R <br /> OESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> � G ,rn , i li�� c��� z42�' G���A A�L Q-d=�`t� �Q�2�; y�s-�sz- io <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> ��'-su- �lLS- z32 - �SJ CA�- `17S-2Sz-/o�c, <br /> E-MAIL <br /> c I IZIP P N <br /> L�NTRACT R N, C.Q• G1N$i�'�C7i.;S� LLC A �.0,6�C% �.3��/ OGkl�q,�'P,�'� (�, .�-675'Y?rU <br /> CONTR.UCENSE# NGC�L-OC L� ��S l�� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �v i Q � �(1 Electric _Gas_Other �L�7S d J <br /> WORKDESCRIPTION ti iY» �,�CTE� To MEw 6AS ��<{= Lpc��v <br /> �un� CMaS L: c= r� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR I7EM NO. TYPE OF FI%TURE OR ITEM <br /> Toilel A/C-air handling uni�s <br /> 6alhtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler healer <br /> Kilchen sink 8 disposal Gas fireplace <br /> _ Disiiwasher � Gas range <br /> Clolhes washer Clothes dryer <br /> Water heater Range hooG <br /> Sink (service/badmop/elc.) Exhaust fan <br /> Bar.kOow prevenler Heat pump <br /> Urinal Unil heater <br /> Drinkin� Founlain . Boiler <br /> Floor drain Refrigerelion <br /> Grease lrap Woods�ove <br /> Roo(drains Olher <br /> Olher <br /> qTY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> I hereby ceritify Ihat I have read and examined this application and know lhe same to be Uue and correcL All provisions of laws and <br /> ordinaces goveming Ihis type of work will be complied wilh whether speci(ied herein or n^t.The grantiny of a permit does not presume <br /> to give authority to violate or cancel ihe provision of any other stale or local la�v regulaiing construction or the perlormance of <br /> construclion.That I 2m authorized by lhe owner of this {:roperty to perform the work for which applicalion is made and I comply v✓ith Ihe <br /> Stalc Conlr�ctorS�'aw 1f32aRCW and 296.200 WAC. � <br /> �'�1.,'- C'/ '' ;---'� // ` 7 ��..� _ <br /> ,Stgnature of 0 edContrac�odAuthorized Agent � Date <br /> �---- — - <br />