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I��RMIT APPLICATI(�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 93201 <br /> 425-257-8810— FAX 425-257-8857—vwvw.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N P�tMI�il <br /> z z n l� �1,� G_T w��R� la Y E p o �{ 3 `I I �1�i 9 L� 3v 0 p ���I ��b� �� � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. i �` �� ') �j E Y E�z G 7'1� F�L AT' <br /> OWNER ADDRESS CITY2IP PMONE <br /> �n)� Ll. i �� �., TF(o�» �sp �J �I � �o � SKhc �T �:� rXF �n GO '�G2Ffp �r`�_z37 <br /> TENANTNAME CONTACiFORPERMIT PHONE <br /> I-S�^` E�OLDG�1 y 25 . 7 �i4 307� <br /> CONTRACTOR Y��-L C l i��e'T� I-(TC- ADDRESS CITY2IP PHONE <br /> , 75c7 NE �� 7tC � , �fp.�c�.ln yzs-7aG- ;o7� <br /> 9 �Sz <br /> CONTR.LICENSE N � L l. C �-�H 1 ({ I� C-6 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PR�CE OF WORK <br /> _Electric�Gas_Other � � 0 0 0 �" <br /> WORK DESCRIPTION [ (� <br /> ,;t..��.�erec ,,r�. �J.,�tc —f��t�.., I �,r��„ Tt ilJU.ti�,_ .hr:-tu,a., � �' _t�art-tc —YeL�t'.a- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXNRE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilot fVC-air handling unils <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) � Gas piping - 3«�H 4 � �y���` -��"'{"'' <br /> Shower Waler heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(service/bar/mop/etc.) Exhausl fan <br /> Backflow preventer Heat pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap _ Woodstove <br /> Root drains Otber <br /> Olher <br /> CITY Of EVERETT LOC4L SALES TA7(CODE IS 7105 <br /> I hereby ceriti(y that I have read and examined this application and know the same to be true and cortecl. All provisions of la�vs and <br /> ordinaces governin�ihis type of work will 6e complied wilh whether specified herein or nol The granling oi a pertnit does nol presume <br /> to give authority to violale or cancel lhe provision of any olher state or local law reguiating conslruction or the peAormance o( <br /> construction.Thal I am authorized by tha owner of this property lo perform the work for which application is made and I comply wilh the <br /> State Conlraclors Law 18.27 RCW and 2962Q0 WAC. <br /> \�. nn , c l ���_��i - 1 - .id- n % <br /> S�Jn Wre o(OwnedContredodAulhorized Agent Date <br />