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. .� <br /> � � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-881 D—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N PERM T# <br /> �-► � ► Ruc�u..�`ti. �EN u�' ooa�s$o osoo ' �� - � I <br /> LEGAI �,.10iNQ.��,� BLOCK TRACT OR SUBDIVISION• <br /> DESC. ��'�� D �-D•DD �VE�iT DN � P�� <br /> OWNER ADORE55 CINIZIP PHUNE <br /> �04�N`4�4�41��t1Tht,lE� l"?ll �IAUC.�2. /�fG �J�{l—q�'d�01 ��-��{ <br /> TENANT NAME CONTACT FOR PERMIT PHONE � `1 �a {`p <br /> '�" '� `~ �1�� E�h1A1LUL�l a.u� fher .o►z� <br /> �►1�r� P�Au.uN-�►-� �i4 R�� � " -a�i�) <br /> CONTR.LICENSE D _// ��1 y3S I <br /> �oNNiRto24MN 3 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> '��p�� _Electric �Gas_Olher � I�i�' <br /> WORK DESCRIPTION <br /> Kcrzkr�!I R�G�- -� F�K«�f RoaH haomaN ��p S a./,� <br /> I,A+�►J�(�V R00►1 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> Toilet A/C—air handling units <br /> �athtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> (� Kitchen sinh 8 disposal I Gas freplace <br /> �� Dishwasher 1 Gas range <br /> �� Clothes washer � Clothes dryer <br /> Water healer � _ Range hood <br /> Sink(servicefbadmopletc.) � � Exhaust fan <br /> Backflow prevenler Heat pump <br /> Urinal Unii heatcr <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> '� CITY OF EVERETT LOCAL SALES TA%CODE IS J705 <br /> I hereby ceridy that I have read and examined Ih1s applica6on and kno�v ihe same to be�rve and correct. All provisions of laws and <br /> ordinances goveming this type ot work will be complied wdh whether specifed herein or nol The granting ot a permit does not presume <br /> to give authomy to violate or rancel the prowsion ol any other state or local law regulating constn�ction or the periortnance of <br /> construction.That I am authorizea by the owner of this property to perform the work for which application is made and I comply wlth the <br /> S Contractors Law 1827 RCW antl 296200 WAC. <br /> s�a�f• ra <br /> SignaWre ol Owneri�ontractodAuthonzetl Agent Oate <br /> ( I� <br />