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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320C CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />2-qu, t z'i_—e 1e Atwe <br />PARCEL TAX I.D. # <br />o045*694-c7l gGG <br />PERMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />-1 <br />DESC. S - 2. 7- <br />(O 01.4 D <br />OWNER ADDRESS CITYIZIP PHONE 4LS_ <br />Firs} Ill'¢sb*vranCAtjrc,� 2q3& R4'::'4ejV(1 ft me 5WWfit %¢271 25a1- }13q <br />TENANT NAME CONTACT FOR PERMIT PHONE�ZS�25'"/ ".3/bl <br />— Mlc�ue l t <br />/-f� �l+� <br />L <br />j/�elMaln /wain/ EMAIL �(C I�C/i�/C{nNN•h2 <br />CONTRACTOR E $ CnIZIP—PHONE <br />CONTR. LICENSE# y EdG�e ff- 42•S-�9 -040/ <br />141,kTGAL95'/)�: Sq /02 %9208 <br />USE OF BUILDING <br />HEAT SOURCE <br />k <br />CONTRACT PRICE OF WORK <br />,L�� <br />69//ieiars �Gl�/lJi/ /BS <br />Electric —Gas —Other <br />WORK DESCRIPTION <br />Al,i, U rk- aSaA�(�/tF/{ lv/-b�' p�idS� �0 be- /n C'A4 Yvly Ai/c1//z, GOhs(Sf- Wo <br />N-i'�0�//7J/ I SdS!»(G isb&sA9satAA+eAehf, M/'l�1Ce L£(//I' <br />oh fhi�d ,Char . <br />PLUMBING <br />MECHANICAL <br />NO, TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />_ <br />_ <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinanzes governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />co r lion. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />St to nlraclors Law 18.27 RC1N and 298.200 WAC. <br />nature of ewneffeon4fat4 Authorized Agent Date �L <br />