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PNIKMIT APPLICATIA <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 /> APPLICATIONSAREACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS 21 1 <br /> I PARCEL TAX I.D.# PERMIT# <br /> Roy-/- Akk!., X 15O(c -OO6 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> fnE- mete SJ e)by/ Dbn 0In 50,855- Z(o(05 <br /> CONTRACTOR Rt9h1(n2Ly { tArvo Fl(�C`}0w DR(/,7_ a S CITY/ZIP3PH455- / &5 <br /> CONTR.LICENSE# } r��- bc' C0 vJ c-Ci <br /> �ZGN1+)P D 7l�5 1430011ey/ +' °g Z-64 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> (-i- Cey\}ex _Electric X Gas_Other I (9Z 7 <br /> � P 70 C <br /> WORK DESCRIPTION <br /> —7561(x+ '0 r\ p c 7 ca3 \r\anA 1 e t'S 1A9( o RC+1 r 16 ct4 <br /> \,yo)(473I1;C (24 c N I CA• ,T ii o2 7;Z-if, 2 lavr, 3 .946- <br /> PLUMBING <br /> " /CsPLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet 7 A/C—air handling units <br /> Bathtub Forced air systems /\ /)*`t <br /> a Lavatory(wash basin) Gas piping l/t/ <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace t61036161 <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> r Laundry tray Range hood <br /> .J Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces 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 state or local law regulating construction or the performance of <br /> construction.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 /> State Contractors Law 1 ' 7 di;nd 296.200 WAC. <br /> Signature of Owner Con ctorized Agent D to <br />