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1. <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CECIAR STREET, EVERETT, WA 98201 G-l3 -07 <br /> 425-257-8810- FAX 425-257-d857 -www.even�ttwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM SE/-�'l D`J�D�D S� <br /> SITE o�DRESS ' PARCEL TAX I.D.# PERMIT'�� <br /> /�� Q.tiY1G!'J1J Q6394�00000�ico � c2o���yaz m 7 <br /> LEGAL LOTNO. BLOCK TRACT � /�- p /��� �T <br /> DESC. �o � " Wl p' �UCJ�,NeY ` " <br /> OWNER ADDRESS CINIZIPy���ZPHONE <br /> �v�,er,�Ey �ou2r �L� i�FGo� �a�.c,� i7QS� /11iccEer� W� ¢zs •35�-6�8� <br /> TENANT NAME, CONTACT FOR PERMIT VHONE <br /> � . �HA4cFS l�oIEGAN . �25- 353-e2BS�S ' � . <br /> CONTRACTOR AD�RESS CITYIZIP PHONE <br /> CONTR.UCENSE# � � � - ' <br /> • � : .•i <br /> USE OF BUILDING I — HEAT SUURCE I CONTRACT PRICE OF WORK <br /> � � <br /> S/NGLC I'H����y /��NNomE Electric �Gas Other /`� p0 D <br /> WORKDESCRIPTION e6�.S,eL�� �� ��,v��E ��micY TwN �"6S (�Lt2.l.-�" � <br /> l.�si c� -Tawn house, �Jra-� - 7y�. `z <br /> PLUMBING M11ECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF PIXTURE OR ITEM <br /> � Toilet � A/C-air handling units <br /> 1 Batlilub � Forced air systems <br /> � Lavalory(wash basin) � 7t Gas piping <br /> Shower � Water heater <br /> � Kitchen sink 8 disposal � Gas fireplace <br /> / Dishwasher � Gas range <br /> �_ Clolhes wash:r / _ Clothes dryer <br /> Laundry tray � Range hood <br /> Sink (service/badmop/etc.) g� Exhausltan <br /> BackOo�v preventer Heat pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> Floor drein Refrigeration <br /> Grease trap Woodslove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby ceritify tha� I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing lhis type of work will be complied�vith whether specified herein or nol The granting of a permit does not presume <br /> to give authority to violale or cancel the provision of any other slate or local law regulating wnstruc�ion or lhe performance of <br /> conslructiun.That I am aulhorized by the owner of this property to perTorm the work tor which application is made and I comply wilh lhe <br /> Stale ConVaclors Law 1827 RCW and 296200 WAC. <br /> `�� � ��t� 23 APiL O'J <br /> Signature of OwnedCont A or/Aulhorized Agent Date <br /> - -- - -- - - - --- ---- -- `� v <br />