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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI'f, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCcPTED FROM 8 AM TO 4 PM I l .� �Q �Dt� <br /> SITE ADDRESS PARCEL TAX�.D.# RMIT 1t S.S� <br /> 24z� MR�� �r. �� z9asZ��is� �4-� v - <br /> LEGAL LOT NO. OLOCK TRACT S� 7p'IWY y� �� �^67J$E� �lL�1�.5 FT N � <br /> oesc. i4q.ps: w � c�nr+� q. Y E 'iHN i gr-rt� w vzo <br /> OWNER ADDRESS CITYlZIP PHONE <br /> Mn? �Vo N 2<I';.Z NWPc� Sr. T>I '�£�( �zo� 4z5. ��'r.QS7S <br /> ItNANI NAMh GUNIACI hUkPEkINIi FHOfiE I� <br /> -��,� ��u�� I��N G���N ��:Z3,. �«. I <br /> CONTRACTOR ADDRESS CITYILP PHONE <br /> c�vePs►r� Cor���. ��`- �-��b cRor�weu, ea MeN�. 4�Szrz '�2ai.��z� <br /> CONTR.LICENSE A <br /> C�n f�T��)S''df�P� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���I� Fq�i�� �p�k� I _Eledric xGas_Other �j5���, B� <br /> WORK DESCRIPTION 'fZ� - �P��' R��'�Z R's� � 'Fi«"l PF�`MPTf�- FosnFql'{e/v <br /> W�TF4 CaNGW�"� � R�Pa�fL R��R DeG�L � �'A��R3. <br /> �� I.�.ct�-� 3 C� " !��d�.,�- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUCTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel AIC—air handling units <br /> BalhWb Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shovrer Water healer <br /> Kitrhen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/elc.) F�chaust fan <br /> BackOow prevent=r Heat pump <br /> Urinal Unit heater <br /> Dnnking Fountain Boiler <br /> Floor drain Refngeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cenlify Ihat I have read and examined this application and know lhe same lo be We and correct. All provisions of Iaws and <br /> ordinaces governing this type of work will he complied with whether specified herein or not The granting ot a pertnit does not presume <br /> lo give authonry to vio te�r cancel the provision of any other state or local law regulating consWclion or the pe�formance ot <br /> censt tion. Tha 4 thorizedby the ovmer of this property to per(orm the work for which appliwtion is made and I comply with the <br /> State ntrado .7 and 296.200 WAC. <br /> d� <br /> S n0lur o d ontra od u orized Agent � <br /> � <br />