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� <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-vuww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PflRM1T 11 <br /> 1401 �G�EIt- o�E3�-t oona�coloo PacQ.�r-aG <br /> LE LO1N0.� � BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CRY21P PHONE u2s'" <br /> �F. (����u�AM� L,Q Iq�lot �IQ�avE w. Sucr� � ��,°�3� ce�a-9aya <br /> �� O Nawe P I c��TCoI�VA{S �"'1'ZS- 3H71d --G-14� <br /> �.�►oPlN�riJr L� <br /> CONTRACTOR(��'�,� _ 0,,,���-n I� �3sy� �� � ��cirrrzir PHONE <br /> v��� f WMI�V I,�.� <br /> CONTI2.UCENSE NO�•�J4 PX I-L�/'� 4�DDW��NGIR �SOIZ. "{VS��—L(.�� <br /> USE OF BUILDING I HEAT SOURCE ( CONTRACT PRICE Of WORK <br /> ������� �Eiadric Gas_Other 1 <br /> I <br /> WORK DESCRtPTION�� 1 <br /> �11.vW��l�f Za _ N�.1rJ C�►�fi�uu-torJ 11M,��"�FMi'U�u-1 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flJ(TURE OR R'EM N0. TYPE OF FIXTURE OR ITEM <br /> Toiiet A!C—air handiing units <br /> 6athtub Foreed air systems <br /> ?•o Lavatory(wash basin) Ges piping <br /> Shower Walerheater <br /> � Kitchen sink 8 disposal Gas firoplzce <br /> �;L Dishwasher ' Gas range <br /> �fQ Clothes washor Cblhes dryer <br /> ,j� Water heator Range hood <br /> Sink(servicelbar/mop/elc.) Exhaust tan <br /> Backflow prevenler Heat pump <br /> UAnal Unit heater <br /> � Drinking�ountain Boiler <br /> Floor draln Refige2lion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITV OF EVERETT LOCAI SALES TA%CODE IS 7105 <br /> I hereby ceriUfy that I heve read end examined lhis application and know the same to be true and conect. All provtaions of laws and <br /> ordinaees goveming thia type ot work wlll be complled wilh whelhel spec�ed herein or not.The granting of a pormit does not presumo <br /> to qive aUtho ' to violale or eancel the provision of any other slate or local law repulating construction or the performance of � <br /> construdion at I am au o ' ed by the owner of this properry to poAorm the work for�vhich epplicatlon is made and 1 comply with the <br /> State Con rs Law 1 CW and 296.200 WAC. � <br /> d�--� � In D (0 �11 <br /> Signa e o er n ctoNAutho�zed Agent ate ��\�v <br /> �O <br />