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� PERMIT APPLICATION -1 <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 /> APPLICA'�IONS ARE ACCEPTED �ROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.k PERMIT# � <br /> �30o M�=�tiu. u�.=�c �Kw� So <br /> LEGAL !OTNO. BIrICK TRAC; <br /> DES�. <br /> OWNER ADDRESS ��TY�Z�P �,�i� aZS���� <br /> WA R.E. Ha��Ni�s b��oP loo� uN�V��ts ,ry sf -�282o S�ATTLE 98�� 1 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Ro��S RoYGE IS�F �GHUL'tZ y2S '451 - 80oK <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> S1vN �1.H '�'�O M���� �-�� pKWy � -�75-744y <br /> CONTR.LICENSE M1 �f�� ' wA C��/LO3 <br /> Crci s� �N'rt.� 9y6GP <br /> USE OF BUILDING I — FIEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric _,Gas_Other b �y�S'�,5 <br /> WORK DESCRIPTION <br /> I .� lu.und� 1VRT�D flc'T�le�or S�bN <br /> �i PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> IToilel _ A/C—air handling units <br /> � _ Bathtub _ Forced air systems <br /> _ Lavatory(wash besin) _ Gas pipmg <br /> Shower _ Water heater <br /> Kikhen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clolhes washer _ Clothes dryer <br /> Ran e hood <br /> I� S nk(serv ce/bar/mopfetc.) _ Exhaust fan <br /> �� Backtlow preventer _, Heat oump <br /> � Unnal _ Unil healer <br /> 'i _ Drinking Fountain _ Boiler <br /> Floor drain _ Refngeralion <br /> Grease trap _ VVuud�tove <br /> � Roof drains _ Olher <br /> I Other — <br /> ' CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that 1 have read and examined this application and know the same ro be true and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether speuhed herein or noL The granting of a pertnit does not presume <br /> . ro give authonty to violate or cancel the provision of any other state or 1oc21 law regulating construction or the peAormance of <br /> i conslruction. That I ar authorized by the owner of this property lo pertortn the work for which applicaUon is made and I compty with the <br /> I State Ccntractors Law 1827 RCW and 296200 WAC. <br /> IISignawre of OwnedCortraqodAuthonzetl Agent Date ��L <br /> �--- — <br />