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� <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE I, EVERETT, WA 98201 <br />425-257-8810 — �AK 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROh1 8 AM TO 4 PM <br />SITE ADDRESS <br />i <br />t��,,��.,.. � � - <br />LEGA LOTNC. BLOCK <br />OESC. <br />OWNER <br />� �c:� Zo1c� , <br />.>l:�lP1r.0 y �C1i�lvl�. i�� <br />TENANT NAME <br />S t>..s <br />PARCEL TAX I.D. # <br />TRACT <br />CONTACT FOR PERMIT <br />CONTRACTOR ADDRESS <br />� c vJ E�c ^, ��. � r Qp c,L;,,,' � <br />CONTR. LICENSE p � <br />USE OF BUILDING <br />���r¢ <br />WORK DESCRIPTION <br />%1 e _,,.� (loo-�' , <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />,� Electric _ Gas _ Olher <br />PERMIT # <br />3v�o 5.0���- <br />{ �, �ao�-� l�ia s � � �, �; a� <br />PHONE <br />!--� a,S � ��, 5 a�,��-� <br />CITY2IP PHONE <br />CONTRACT PRICE OF WORK <br />� � \ , IcL�YJ. <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryor <br />Rangehood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Retric�eration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby ceritify thal I have read and examined this application and know lhe same to be true and correct. All provisions ot laws and <br />ordinaces goveming this type of work will be complied with whether specified herein or noL The granting of a permit doos nol presume <br />to give authority to violate or cancel lhe provision of any other slate or local law regulating construclion or the per(ormance of <br />construclion. That I am aulhorized by �he owner of this property to perform lhe work for which applicadon is made and I comply with'he <br />SFat�C\ niractors Law 18.27 RCW and 296.200 WAC. <br />\_ ` <br />_ '..� l0 ra,�,� �n�. , -,� �, � 3 I 1 � � (� � <br />