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P��RMIT APPLICATIUN <br /> CI'TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERt l�T, 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 PARCEL TAX I.D.# PERMIT# <br /> ! � Z. 2�� Z�J �t.ti.5�� �aos73C� D0003�0� �(�= / <br /> DESCL� L�NO. l3LOCK T�2%�'�` /� � <br /> � J La� �"`C <br /> OWNER ADDR�.°SS CIN21P PHONE <br /> 36�,•�:�• �eu� <br /> /I�.,�f �:e11.��. J8� �!;;� 1 �h�� C����,�� .�. uJ� I�zbZ. <br /> TEIIAN7 NAM�^ CONT,4CT FOR PERMIT � PHONE <br /> N ��� <br /> CONTRACTOR �jP,�CG.r,�,) �..�1 �Z„•�:�, ADDRESS CITY2IP PHONE <br /> n�<.ys�,�, , Wn �!�-L7v <br /> CGIJTR.LICENSE N <br /> USE OF BUILDING I — HEA`SOURCE CONTRACT PRICE OF WORK <br /> 5�1�— Eleclric Gas Other <br /> WORK DESCRIPTION ..�. /' I <br /> l�unv o� lle�.eu� � <<��,J.�.�.,,�! S�:,SI� tR.u,�N YIJNu. A"c� ol�.,� �in�, <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIxTURE OR ITEM NO. TYPE OF FIXNRE OR ITEM <br /> Toilel A/C—air handling units <br /> BalhWb Forced air systems <br /> Lava�ory(wash basin) Gas piping <br /> Showe Water heater <br /> Kilchen sink 8 disposal Gas fireplace <br /> Disliwasher Gas range <br /> Clothes washer Cbthes dryer <br /> lValer heater Range hood <br /> Sink(service/badmoplelc.) Exhaust fan <br /> BackOow preventer Fleat pump <br /> Urinal Unitheater <br /> Drinkinc�Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Foof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cerilify thal I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> o•dinaces goveming Ihis type of worA will be complied with whether specified herein or noL The granting of a pemiit does not presume <br /> tn give aulhority to violate or cancel the provision of any other slate or local law regulating construclion or the pedormance of <br /> coustruclion.Thal I am aulhorimd by the owner of Ihis property to pedorm the work tor which application is made and I compty wilh the <br /> Slate Conlraclot"L w 1 .27 RCW and 296200 WAC. n <br /> �� � �/�,C/k+ <br /> Sign�el'OWn�Contractor/Aulhorized Agent ate <br />