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PERMIT APPLICATION <br />PERMIT APPLICATIVN <br />Es <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 <br />SITE ADDRESS <br />5011 Seah�rst Avenue <br />PARCEL TAX I.D. # <br />25oY36-ao3-o62-0O <br />PERMIT N <br />LEGAL LOT NO. <br />BLOCK <br />TRACTOR SUBDIVISION p <br />DESC. <br />— <br />OWNER ADDRESS CITY/ZIP PHONE <br />S-><eVen 7 'g°re-ios 5011 Seahors{ Aver EvereF-1-,LJ/� 98a03 CS�'�ZZI�OO°I <br />TENANT NAMF. <br />CONTACT FOR PERMIT PHONE <br />Lea - t ti y Z <br />owl ter' <br />,� <br />out ne r �-MAIL _ <br />Y. <br />ON RACTO RESS I I PH N <br />ownC.r' <br />CONTR. LICENSE p <br />--USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />lee 5 � den' 0.I <br />�'Flrectric ✓Gas _Other <br />b <br />II_yI__ <br />WORK DESCRIPTION '{ZeS�"or'FJ 2. y2 Tool' o� ng ytouSe '�f0 <br />br;9;nu� cons+r-ucl-;o1r, 6�-i-ween exlSt��S Svb-�loorin� d-' <br />C'><ist;n r-�J5� Itogrq , '+nclua'r19 -t-a110.-4'�on o� yelec-l-rical �c.-p-h"calS <br />an roe�Y'eDa>�r, a5 rteede <br />PLUMBING MECHANICAL <br />1 <br />p._ <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shaver <br />_ <br />Water heater <br />_ <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink(serviceNar/mop/eta) <br />Exhaust tan <br />_ <br />6ackflow prevenler <br />Hcal pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />_ <br />Other — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerilify that I have read and examined this application and know the same to be True and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stale C ntraclor Law 8.7 RCW and 290.200 WAC. <br />j ° <br />-� Ow)M1crr o91e �z <br />Signature of <br />