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n.'. Ll. L:� Y..,n,� 40.1§99 P. 2 <br />i <br />PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425 257-8310 — FAX 425-257-8857 -- www.everettwa.org <br />ll <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM q , /v <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />l 10 /q v .. a e <br />�b �8833 3 Ohs tflp� <br />�) � — J�- <br />LEGAL LOT NO. <br />ULOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CITY/71P PHONU <br />&Q- 4 L Pia -- f b r'1y rw ,^ 1, Ct 44-` t sA 98,76f tfa-�"L99 a <br />TLNAN1 NAME <br />CONTACT FOR PERMIT PIfONE 31oy 'i9v <br />I <br />L-�+�^Y+ D E-MAIL iQu•'w Oct <br />(. NTRA 1OR AUURLS CI1 2 <br />& - S P✓...--,I Lrx 1, �f , j �Sl.s t.,� 17'� n-M E tV ..:S+ 9 ff-' Z70 '>,a0 74 v 7 s <br />CONiR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />5. 1. `tom. �, y (��,5�„�� <br />L'Electric Gas_Other <br />I <br />p O� <br />WORK DESCRIPTION 2�,{a, .. tti0in �. e�-1✓+y jeLS '1"( <br />PLUMBING <br />MECHANICAL <br />NO. IYPE OF FIXTURE OR ITEM <br />-..� <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />__ <br />Gas piping <br />Water heater <br />_Shower <br />_ <br />Kitchen sink 3 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mopletc.) <br />Exhaust fan <br />_ <br />0ack8ow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boller <br />_ <br />Floor draln <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />Other <br />I <br />.CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby certify that I have read and examined this application and know the some 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 />constmction. That I am authorized by the owner of this property to perlorm the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />i LJ� coca, �_.._ ,_ �(/a� i to <br />Signature or Dwner/Contsmator AAuUtodzed Agent Date <br />CDu <br />