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PL.ZMIT APPLICATICS�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425•257-8810— FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT[ADDRESS PARCEL TAX I.D.# �PERMIT# <br /> U (�L PiL i2. ob' . Z goo 3�0 3o i L� /CO3 '�'� � <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION p <br /> o�sc 3 s_V_C-���/ NiuJ D/U,S�ort l S (� 0�`i - O 7 ! <br /> OWNER ADDR[SS CITYIZIP PHONE <br /> l.✓�KCc.��v� I�n�Es Tn � P.o. i5ox bv,9 LAv.e Sr�yu�S , Wv� 9�z� �}zs-3si, -r���� <br /> TENANT NAME CONTACT FOR PERMIT PHONE yrzS. 3SG 7ZL ) <br /> Sr��- VJIa1✓1-B�S E•MAIL I <br /> CO— TRl�R S��� ADDRESS CITY2IP PHO E I <br /> CONTR.LICENSE M � ��GL �I <br /> � F!I ooi�L (,o� �ZZ (�L.i <br /> �. USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> S�'� _Glectnc �Gas_Olher i <br /> WORK DESCRIPTION � <br /> -(�+�S=i � � ` 1= I <br /> ��� � � � �� � ��� <br /> PLUMBING MECHANICAL ' <br /> NO, iYPE OF PIXTURE OR IT[M . NO. TYPE OF FIXTURE OR ITEM i <br /> ,j Toilci — ----- AlC -au handlinc� unils �'� <br /> 2 �athtub Forcea air systems I <br /> Lavatory pvash basin) 3 Gas piping <br /> Shower I Water hea�er ' <br /> �_ Kilchen sink & disposal 1 Gas hieplace I <br /> / Dish�vashei 1 Gas range <br /> _j_ Clothes�sashci 1 Clothes dryer <br /> _� Wale� hcaler �_ Ranye hood ' <br /> Slnk (servlcelbadmop/etc� 3 Exhaust fan <br /> [3ackliow prevenler Heal pump <br /> Urincd Unit heater <br /> Drinkiny Pounlain Boiler <br /> Ploor drain Refrigeraiion <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hemby cehify Iha� I have read and examined Ihis applicalion and know�he same lo be�rue and correcL All provisions o(laws and <br /> ordinances governing Ihis type of woik�vill be complied with whether specified herein or nol. The grantin�of a permit does not presume <br /> to give authority to violale or cancel ihe provision of any other stale or local law reg�dating conslruclion or the peAormance of <br /> constiuction. That I am au(honzed by the owner o(Ihis propeily to perfonn the work for which application is made and I comply wilh ihe I <br /> S1aIe Con�ractors L2v+ 18.27 RC and 29� 200 WAC <br /> - , 8�6I�p <br /> I SignaLue bf-II�AContrac�oi%Aulhonzed Agenl Da�e � <br />