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�-�v-cd <br /> i <br /> PEr�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- F AX 425-257-8857 -www.everettwa.org �07��I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTFD <br /> SITE ADDRESS �(�O l PARCEL TAX I.D.# I� PERMIT# <br /> 14 `u � E�� M►t�.iN� u�t-w DR I I"J29U5 loo5UU0 r�n <br /> LEGAL LOT NO. P•LOCK TRACT � - <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> C�1WppL� D�VO�Pntt�l.r 3�9 S�Iu �htiC�u� P�� #�5 N�vP� P,�cN <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �xxtz �'A�ir�c 32%� Tt�G¢�eQA � f��+��H+�m �o- 734-Z��2 <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Olher <br /> WORK DESCRIPTION <br /> R.C-'r�i�.�WG tuM�s IH Pn�zku�G w-r � p2ept-��Y u�vE <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Bathlub Forced air syslems <br /> Lavalory (wash basin) _ Gas pipina <br /> Shower W ater heater <br /> Kilchen sink&disposal Gas firep�ace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(servicelbar/mop/etc.) Exhausl fan <br /> Backflow preventer Heal pump <br /> Unnal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeretion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY 01�EVERETT LOCAL SALES SAX CODE IS 7105 <br /> I hereby ceritify that I have read and examined th s application and know the same lo be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be com�lied�vith whether specified herein or not.The granting of a permit does not presume <br /> to give aulhonry to violate or cancel tne provision of any other state or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of lhis property to perform the�vork(or which application is made and I wmply with the <br /> State Contrectors Law 1827 RCW and 296.2001VAC. <br /> � � � JVLb� <br /> Signature of OwnedCo cror/Authonzed Agent Date <br />