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,_ _—__— . �_—�— __ <br /> ' ��ERMIT APPLICATION ���`- � <br /> CITY OF EVERETT PERMIT SERVICES ;'�"z1�" <br /> 3200 CEDAR STREET, EVERETl', WA 98201 <br /> 425-257-8810- FAX 425-257-8857-�vww.everettwa.org <br /> �� :,PPLICATIONS ARE ACCEPTED FROM 8 Ah1 TO 4 PM — <br /> SITE ADDRE-SS pARCEL TAX I.D.# ERA1IT# <br /> -�'fi2- 3 f�a �}r,c, ,SC Cc�:s ,� -oav �o i. - o� � 7(� `� - � _ <br /> LEG:.L LOTNO. �LOCK TRACT <br /> ��=5�. cl.�,f /� o�' Cu�t G��✓c N ���1�� <br /> OIYNER ADDRESS C fZIP PHONE <br /> /'r�i',^��!< �Li4,^�rS �,.»f %.r�, Gz(s/15 NE�i91.d G-Sf �/ Jf'cur;t5 9J'23� <br /> TENANTNAh1E � CONTACTFORPERIdIT PHONE <br /> i <br /> __� . . .� f��� lJoS��L � � '� f!'...ZJ ' �t3"L.-.�.-7� <br /> CORTRACTOR "�. '�+�. � A08$ESS • ' ChiY21P' ��' PHONE � <br /> Trr�c'.'I��c G'/i�-,•/rs �o�sYfu, 62l S/'iSN� Pil/ij G-3' G/< S�c✓�S • <br /> CONTR.LICLNSE# . <br /> F,�������,s�o� �� ��JI�I�-; . �_�' : <br /> USE OF BUILCING HEAT SOURCE � � CONTRACT PRICE OF WORF: '� <br /> �'�� I �Electric _Gas_Oth�r I �/U�J,�QU - �il <br /> � IVORK DESCRIPTION ' <br /> , ':�`'� �`''='`_ r�i��s � �z ��� <br /> ������v 2��� � � <br /> � e. 2 � <br /> PLUMBING _ - -- - - MECHANICAL � I <br /> N0. TYPE Of FIXTURE OR ITEtd NO. NPE OF FIXTURE OR ITEId I <br /> � 3 Toilet A/C–air handling units <br /> � Balhtub = Porced air systems <br /> � � Lavatory(wash basin) Gas piping <br /> __(_ Shower _f__ INaler heater �, <br /> __L Kitchen sink 8 disposal Gas fiieplace <br /> i Oishwashcr Gas ran9c <br /> � Clolhes washer _� Cbthes dyer <br /> � Water heater �_ Rangc ho ri <br /> _ Sink (servlce/badmopleta) � Exhaust I.in <br /> Backllow provonler Hoal pun�,r <br /> Urinal Unil hca;��r <br /> Drinking Fountain Ooiler <br /> Floor drain RofrigeraG�n <br /> Grease lrap Woodstove <br /> _�'. Raof drains �/ _ Other ____ <br /> I Other <br /> I <br /> , CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby ceritify that I havo read and oxaminod lhis application and know the samo to bo lruo antl corroct. All provislons of laws and <br /> ordinac�s goveming this lypo ot work will�o complied with whether specified herein or noL Tho granting of a permit does nol presume <br /> to give authoriry to violato or cancel th��rovision o(any olhe stalo or local law regula6ng conslruction or tho performanca of <br /> constructior,.Thal I am aulhorized b �ho owner of this pro rty to periorm tho work for which applicofion is mado and I comply with u��e <br /> State Contractors Law 18.2 RC ; nd 296.20 �INA�„� <br /> 1 ��� �/ ' l��c V � <br /> S;gnaWre o(Ownor/Conlractot/Authorize en / D te � � <br /> � L <br />