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f � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S T REZT, EVERETT, VJA 98201 <br />425-257-8810 — FAX 425-257-885•i — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />SITE ADDRESS I PARCEL TAX I.D. # I PERMIT # <br />5 70 -w(� <br />LEGP.L LOTNO. I FLOCK TFACT <br />DESC. i <br />�� ��✓,+C I u'Lt'T l�tx l�-u:: �t'Ga G�ti �45:�1 u• <br />1:CPtir; rl ;.L41JlC <br />TENANT NAME <br />CONTACT FOR PERMIT Pnunt <br />CUf ty L.Jt+nt._ `IZS l-i`� 1tii4Lt <br />CONTRACTOR ADDRESS CITY01, PHONE <br />.. 6300 mr-efIL, 2eEerr1 tLwy. NL5.775•i'i'{'-; <br />CONTR. LICENSE# <br />USE OF BUILDING <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />r jjl, . ` <br />'1 SLJ G <br />_Electric _Gas_ Other � <br />WORKDESCRIPTION/)r��' /r�i/,/f,!✓fr� <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />AIC — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas Piping <br />_ <br />Shower <br />_ <br />Water heater <br />_ <br />Kitchen sink 3 disposal <br />_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />_ <br />Range hood <br />_ <br />Sink (service/barlmop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Unnal <br />_ <br />Unit heater <br />_ <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Roof drains <br />_ <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby centify that I have read and examined this application and know the same to be true ano correct. All provisions of laws and <br />ordinaces,goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to jut to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />giv lhoyity <br />con cti Thaia-a@ authonz thehwner of this property to perform the work for which application is made and I comply , ath the <br />State Contiotors Lawi . 7 %Nrnd 2b6.200 WAC. <br />122 <br />(/ <br />g e of Ow nertuontractor/Au onzed Agent ate/ <br />