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. � . � ( <br /> PERMIT APPLICAT'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 -www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITe ADDRESS PARCEL TAX I.D.# PE IT M <br /> � o � � r3 <br /> LEGA LOT NO. BLOCK TRACT Boyo°� - ao3 <br /> DESC. S� <br /> OWNER ADDRESS CITY2IP PHONE <br /> �{t�t.L c:�FiEK- F�-pW6S (GCo Je�IJEQS�'�l� ST ��E p� �f� <br /> ��' S.�'�E Z8� 98101 Et_�] 4�S- S*,C,.S <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �DGAl�i �•]i�.v�r►v7 I y�O+R"- '-`�c1' �r1¢�w�sTr�� ��J/�-(�1. y./(� ���[s� <br /> b �,�VL� �i�11F�1���� � V�/7�U' `i�s 7 <br /> CONTRACTOR� AODRESS CITY2IP PHONE <br /> -5� ��PeRp+Tt4-� I SW /soR-T3� ?�FH ,T: Sf4ogfi�r�E C2�� <br /> CONTR LICENSE f S�'j�Z��I I <br /> sCaAGo��1Ko 6y Qs � - , i� - oz� `1$1� �-z.� <br /> USE OF BUILDING�� HEAT SOURCE CONTRACT PRICE OF WORK <br /> I � <br /> wpy��� _Eledric �,Gas_Other � ��'��0�. <br /> WORKDESCRIPTION �� �r �,J��{es �rt�i E.XIS'�1.1b -�-=-�r'��' �«� <br /> �asr�u-- ,-�., a,ieef►�►� ¢�t-�, �_-�-_ �����s� c�,�+o�,.x. c�r- <br /> LA,Jo�iES� w+o�.-1 G��S Ar�P 4,�8 wA� Ir��1u�. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC-air handling units <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water heat=r <br /> Kitchen sink&disposal Gas fimplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mopletc.) Exhaust fan <br /> BackOow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re`.rigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Other <br /> CIN OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> I hereby ceritify ihat I have read and examined this appiication and know the same to be true and correcl. All pmvisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whe�her specified herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel ihe provision of any other state or loral law regulxhng construction or the pertortnance of <br /> conslrudion.That I am aulhorized by lhe owner of this property to perform the work for�vhich applicalion is madc ;rd I comply wilh the <br /> State tradors Law 1827 and 296.200 WAC. <br /> � <br /> 9/� oy <br /> S n ure o wnedCont2 r! uthonze Agent �te T ,/ <br /> —�' r <br />