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� -� 283� - Cclb�; NP� <br /> PERMIT APPLIC�►TION <br /> CITY OF EVERETT PERMI'� ;ERVICES <br /> 3200 CEDAR STREET, EVERETC, WA 98201 �{ `�a4�� <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org i <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���� ��, � z I� <br /> SITE ADDRESS PARCEL TAX I.D.N �RMI�� _ � <br /> 1G02 Pacific Avenue OOH39173700100 <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. Gverett Plat �f BLK 737 D-00, loCs 1 thru 5 <br /> OWNER P.DDRESS � CITY2IP PHONE <br /> HousinF Authori[y of iiverett P.O. ISox 1547 Iiverett, WA 98206 425-258-9222 <br /> TENANTNAME I CONTACTFORPERMIT PMONE 425-348-7100 <br /> s' r . � of �v�re Jom Anthon Communit 1'ransi['���C <br /> anthcny@commCrans.or � <br /> TBD <br /> CONTR.LICENSE X <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> Bus ShelScr _Elec�ric _Cas�Other h�p "� L�' � 7�(j <br /> WORK DESCRIPTION <br /> Re:nove existing pavement and exisCin� site improvements as necessary, <br /> inscall raised transic platform, insCall necessary inirastructure, erecc shelter <br /> structure and install necded amenities. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR I7EM NO. TYPE OF Fl%TUHE OR ITEM <br /> Toilet _ NC—airhandlingunits <br /> 8athlub Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower _ Waterheater <br /> _ Kitchen sink&disposal _ Gas lireplace <br /> Dishwasher _ Gasrange <br /> Clo�hes washer _ Clothes dryer <br /> Water heater _ Range hood <br /> Sink(serviceibar/mop/etc.) _ Exhaust fan <br /> Backflowpreventer _ Heatpump <br /> Urinal _ Unit heater <br /> _ Drinking fountain Boiler <br /> Floordrain _ Refrigeration <br /> Greasetrap _ Woodstove <br /> Rool drains _ Other <br /> Other _ — <br /> CITY OF EVENETT LOCAL SALES TAJ(CODE IS 3105 <br /> I hereby cerilify that I have read and examined Ihis application and know�he same to be true and corcect. All provisions of laws and <br /> ordinaces governing�his type of work will be complied with whether specified herein or not.The granting of a permA does not presume <br /> to give authority to violate or cancel lhe provision of any olher state or local law regulating consiruclion or the peAortnance o( <br /> construction,Tha�I am authorizetl by the owner a(�his property lo perform ihe work for which appiicalion Is made and I comply with ihe <br /> State�onlr c�or LawlB,@7�Fj '.���!�296.200 WAC. <br /> '/���/ /�4�f i/�I �l t E o S� <br /> Signa�e of Owner/ oniractor/Authon z�tl Agent / a e �/`t <br /> / , <br />