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t <br /> � PERMlT APPLICATIOti <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org � ��a,_07 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CAROS ARE NOT ACCEPTED <br /> SITE ADDRESS ',S 6 PARCEL TAX I.D.p P RMIT N � <br /> - ,� `� �m Avc� C� ? i -`�� : � 7-1 �1 <br /> LEGAL LOTNO. BLhOC�K} TRACT <br /> �[SC. �,�I �� Z- �_ ) -I <br /> UWNER ADDRESS CITY/ZIP PHONE <br /> �CkNCT1-I��ANAI�it,��r II',��1ci-,c^„ "t�� t�^n-{Ecc 9r4,IL l�Nr�ic.� � til <br /> T�ANT NAME �� I CONTACT FOR PERMIT PHONE <br /> l�l;i.l>y ril;'��i��ta�-� � -��5� I�' i�1F�:F'�7 ZS��.Y_,3� .. ti:�-��a <br /> CONTRACTOR {..�IILCCUNSIRU��ON�INL ADDRESS CITYl21P PMONE <br /> i�2� f:,N1r>��N� v,�.:7� �ceFn- 4Z7�.Y7Z.3'� <br /> CONTR.LICENSERI{A�.UCi.l��h'�C+�� ��)IrLf� C��LL'� <br /> :1 �OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �L,j7���C�,���L �C Eledric _Gas_Olher -�Yr�•,£L,C <br /> 1YORK DESCRIPTION <br /> Il1 �Cf'l�II'� L�N�i� � � �� ��AMAC�C:.l7 �v:,Tc � t=1RE. �E,W �N�'C.2iJQ FiN�s.-�t_S IN <br /> � . <br /> UNITrjI'. � . �CPA1C �C�'11tiLY.1'�.1'-1pl' �L� PIL � <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> - Toilet AIC-air handling units <br /> �- Oathtub Forced air systems <br /> �l Lavatory�wash basin) Gas piping <br /> Shower Water heater <br /> T Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clofhes washer Clothes dryer <br /> laundry tray Range hood <br /> Sink�service/bar/mop/etc.) � Exhaust lan <br /> Backflow proventer Heat pump <br /> Urinal Unit heat?r <br /> Drinking Fountain Boiler <br /> Floor drain Reingeration <br /> Grease trap VJoodstnve <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> I hereby cenlify thal I have read and examined ihis application and know Ihe same to be true anci correct. All provisions o1 laws and <br /> ordinaces goveming Ihis type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel Ihe provision of any other stale or local law regulating construction or the performance of <br /> wnstrudion.That�am authorized by Ihe owner of this propehy lo pedorm ihe work lor which application is made and I comply wlh the <br /> State Lonlrodor�C Law 1827 RCW and 29&200 WAC. <br /> . / _ /� � 7 ��•'� 7 <br /> Signatu-e of OwneFlC niractodAuthorized Agenl Date <br /> _ � _�_ J <br /> - _; <br />