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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 350CA OWe-es P"e <br />PARCEL TAX I.D.#PERMIT# <br />rir.�C0/ASF1A2>cJ1W0Q)C)/J I <br />M07().�-03/—/ <br />LOT NO. <br />BLOCK I TRACT <br />DESC. <br />OWNER ADDRESS CITYILP PHONE r-{ZS-335 <br />SU M�ChPC�,S 3y0CF1 OGY-eS (:�KyP gi83zoI WG52 <br />TENANT NApE <br />CONTACT FOR PERMIT PHONE g� 1 ta' <br />�,j I I (:.I n r S5e6, <br />`, /�S NI/r-ri`ltli �✓A�% ADDRESSCITY(P PHONE <br />CONTRACTORr <br />CONTR. LICENSE # <br />_USE9P B68 I — HEAT SOURCE CONTRACTPRICEOF WORK <br />Electric Gas _ Other I / /rL ( r <br />WORKDESCRIPTION CrCy-�Qe pv-} l\1 has ujut'meco--t <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />NC - air handling units <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbarlmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />_ <br />_ <br />4- <br />_ <br />_ <br />_ <br />_ <br />__ <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />WoodstRefrigeration <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />Grease trap <br />Otherove <br />Other <br />Roof drains <br />_ <br />Other <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know file same to be true and correct. All provisions of laws and <br />ordinaces 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 state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 1E.27 RCW and 296.200 WAC. <br />v j / <br />