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PERMIT APPLICATION <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 T04 PM � Z ...1� -�b <br /> SITE ADDRESS PARCEL TAX I.D.ll PERMIT 1� / � <br /> �� �-(L��'���� � ���� bS�o <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVIS�ON� <br /> DESC. <br /> �O,7NMER ADDRESS CITY2IP PHONE <br /> /�r� �ve�� �/i�%L 3 9a/ y2S3o� �s-�9 <br /> � - fi�,fi¢�, �uP.��7TG✓.¢ 9�2a/ <br /> TENANT NAME nCONTACT FOR PERMIT PHONE yys�p�y73p <br /> �e.. G✓�'rCl �I/iIIL /�CK��Y/ic� i'+�c�l E-MAIL�caoca�uNN[�i�f.�ICi <br /> L`bRTfCA E53 '"�IT9 <br /> ��Z?iL2� �t�L�Gn/c-� ���i,I�rLnS 2.�6 -/215' i4 uC�5� <br /> cONTR.UCENSEN 2 L'V��e�%, `✓� ��2�� JJi//–�01��� <br /> �UNo�s9s � r ��� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � <br /> �E,�r��� � C'1�.��C �' Eleclric _Gas_Other 11 C�'7� <br /> WORK DESCRIPTION L / /1 �7 �/ <br /> rYl��� �ln� ��lL! +L'SS ,5pr�tsysie.-.r I�i�exT/[.ir.�. -r�- /G-� �."G✓ ��w.at�,� <br /> �r5. fe� A-'776+c�ec� �l��,a�- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet AIC–air handling units <br /> Bathtub Forced�ir�ystems <br /> Levatory(wash basin) _ Gas piping <br /> Shower Water healer <br /> Kitchen sink&dis�osal _ Gas freplace <br /> Dishwasher Gesrange <br /> Cbthes washer Clothes dryer <br /> Walerheater Range hood <br /> Sink (service/bar/mop/etc.) 2 Exhaust tan <br /> BackGow prevenler Z Hea�pump <br /> Urinal Unit heater <br /> Drinking fountain _ Goiler <br /> f=loor drain Rsfrigeralion <br /> Grease trap _ N'oodstove <br /> Roof drains Cther <br /> Other <br /> — — — i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and exrmined this application and know the same to be We and correct. All provisions oi laws and <br /> ordinances governing Ihis type of work will be complied with whether sper.ified he�ein or not. The granting of a permit dces not presume <br /> to give authority to violate or cancel the provision of any other sfate or�oai law reguleting�nsWction ar the performance of <br /> construction.Thal I am author�z d by the owner of this property to periorm the work tor which spplication is made end I comply wilh the � <br /> State CoNradOrs Law 18 j�W and 296200 WAC. / <br /> / � ,�-' _ /2/i�- �o/O <br /> ✓SignaWre of wneqContractodAuthonzed Agent Dale <br />