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P�RMIT APPLICATIOnI <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 9'�. �7 —O7 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT if <br /> 1� I - u .KG n.� 00 y3� 03� 00 00 ��� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. .3�'a' � R�rr D 1 Y, � <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> 1�5��NA�� q �1-IZA$�i"N �C.NUTT SAmE qS 5 ir� HzS 314 3529 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE Agp y� � Q e <br /> u+a . 3a8 . �049 wk, � <br /> �ut�to�n�L iM�S -�mL E�t2A8fYlI��iSA� �Ei�-rT eana� 6,,i�,asrFi�c,�,/sCd VaM a. <br /> Z ES$ �` I I L� <br /> CONTR.UCENSEN Ow „ � A i <br /> �v..— <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �leclric Gas �ther (o r�l <br /> RE.S �DE�c.E — — — � <br /> WORK DESCRIPTION <br /> a�� STuK4 'p�RmER fDF �I'Z P,�l�TH t .� C�05�=T5 ,+.� MAS�E�C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> 'r� ', �Toilel A/C—air handling unils <br /> Dalhlub Forced air syslems <br /> �7 Lavatory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas rangc <br /> Clo�hes washer Clolhes dryer <br /> Water healer Rcn,e nood <br /> Sink(service/badmop/elc.) �� Exhausl fan <br /> _ �ack0ow prevenler .Heat pump <br /> _ Urinal ��� Unilhoater (�ut�� ,�cd;E�� <br /> Drinking i=cunlain Boiler <br /> Floor drain Refrigeralion <br /> Grease Irap Woodslove <br /> Root drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceritily Ihal I have read and examined this applicalien and know lhe same to be true and conecl. All provisions ol laws and <br /> ordinaces goveming this lype o(�vork will be complied with�vhelher specilied herein or noL The granting of a permil does not presume <br /> lo give autl�t w � o icel the provision of any other state or local law rec�ulating construction or lhe performance of <br /> conslruc ' �n. iat I am u hyr' d by Ihe owner ot this property to peAorm the work(or which application is made and I comply with the <br /> State C ntr. to�Law . 7 and 296.200 WF�C. <br /> � -� � �3 p <br /> Signat �ot C l�torl uthoriz A9ent D te <br /> �IZ <br />