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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 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 �[S �PARCEL TAX I.D. tnl I FtrcM1I a <br />LEGAL LOT NO. / BLOCK TRACT OR SUBDIVISION # <br />DESC. dG/t//A <br />OWNER ADDf2, E55 CIT YIZIP PHONE c.vv• �raO,C727L <br />S7 z /j W Sr <br />`NGM:-YZ��sELLC. .�202 _c — lDS <br />TENANT <br />NAAMEME CONTACT FOR PERMI'i PHONE L �Co • olq • �Q/ 3 <br />Ml.cEE /3�✓� 2/DS E GaNSI <br />/O„fRcj E-MAIL <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />%3C.uE 2/ E �' ./ST //•/C- '?o %3v3�3pz /D41V4" 48619 <br />CONTR. LICENSE # Low • 9/9• 74a 3 <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />S�l2Electric _Gas _Other �/-7r'o ZC4J <br />WORK DESCRIPTION ]�'� �•/� Zf-� `f' (__- <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />ICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Toilet <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />— <br />/ <br />Gas piping <br />Water heater <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />/ <br />_ f <br />! <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />_ <br />Clothes washer <br />�— <br />Range hood <br />Water heater <br />6 <br />Exhaust fan <br />_ <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />_ <br />_ <br />_ <br />_ <br />Floor drain <br />V oodstove <br />Grease trap <br />Other. <br />Roof drains <br />Other <br />— <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I 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 />ordinances 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 />construction. That I am authorized by the owner of this property to per,orm the work for which application is made and I comply with the <br />Slate ContragLuu s- %v 18.27 RCW/ij;2g6.200 WAG. <br />�/2 <br />