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F-ERMIT APPLICATIvN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 42F-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM �'j �� 6 _O� <br /> SITE ADDRESS{� PARCEL TAX I.D.# PERMIT 8 <br /> � � CJ I' . : el l7 f � — �3 <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVIS�ON N <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> So��dv;e� C�n-Ir4ctorS 1�.0 3ox ao�13 �v�c.t+ 9g213 `/zss��- �zY> <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> E-MAIL <br /> .. NTRAC OR AO�RESS I /ZIP P ONE <br /> � a��v r-��t,-r- 4ezi3 yLs ���- ��v� <br /> So�nclu,ev cun+Re+�rS � L�x 3 <br /> CONTR.LICENSE# <br /> �oc. � Dc � 9511Sa <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SF � _Electric _Gas_Other <br /> WORK DESCRIPTION <br /> �e �,.o t-IuuSL <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilel NC—air handl�ng units <br /> Bathdib Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Showcr W ater heater <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clolhes dryer <br /> Water heater Range hood <br />" Sink(service/bar/mop/etc.) _ Exhausl fan <br /> Back(low preventer _ Heat pump <br /> Urinal Unil heater <br /> Drinking Founlain _ Baiier <br /> Ploor drein Refrigeration <br /> Grease lrap Woodstove <br /> Roo(drains Other <br /> Other <br /> CIN OF CVERETT LOCAL SALES TNC COOE IS 3105 <br /> I hereby ceriti(y that I have read and examined this application and know the same to be trua and correcL All provisions of laws and <br /> ordinaces govmninc� Ihis lype o(wurk will be complied with whelher speci(ied herein or not.The granting of a permit daes not presume <br /> lo give authoriry to violale or cancel the provision of any other slate or local law regulating consWction or the pedormance o( <br /> conslruclion.That I am autho"rize�iby lhe Owner of lhis property lo peAorm Ihe work for which applicalion is made and I comply wilh the <br /> Stale Contractors La •aCW and 2�J6.200 WAC. <br /> .f� cl'/�i'2CtJ� <br /> Signature ot OwnedCon!raclodAuthorized Agent Dale <br />