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F�ERMIT APPLICATION o; ��-s-,� <br /> CITY OF EVERETT PERMIT SERVICES�1�` ' �__ <br /> 3200 CEDAR STREET, EVERETf, WA 98201 S�N � . <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.orgpL <'J , <br /> BL ��,� <,; <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM J�' � <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT# J� <br /> ZUo C� �����o(�� Pv S 9-O��' <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION R <br /> DESC. � <br /> OWNER ADDRESS CITYIZIP� PHONE <br /> � ,��o �Q K 400 Cq�i�.rnin +i `�[INFru��cS�c �A � y15J16S` �421J <br /> TENANTNAME CONTACTFORPERMIT PHONE 7 \O �T�S S � - �S <br /> V ���or� C��w�L C�;ca�� 1-�«�: N� E�hIPJLS\� �33 C�4515� <br /> Arrvw Sit,� �omP<^y <br /> iuS� 4b�"n�r OAwnwp. CA q4ba� <br /> CONTR.UCENSE�t �aQoWSc Go6� <br /> S �o � 33 �6�i3 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WQRK <br /> \��a`,� _Elecinc _Gas_Other ���� <br /> WORK DESCRIPTION n . � � <br /> Xr�s�� �� � �,�.c��'� �ci_ icX. �, . ,��c,- g� cr ��Y�c�-r� <br /> ��' � T\1 ��\�L� �. e��L�i r�'��.—�'_lt'�a rZ l'� ll)C'\� \L 4 c C �1� <br /> PLUMBING MECHANICAL <br /> NO. ?YPE OF FIXTURE OR ITEM NO. TVPE OF FIXNRE OR ITEM <br /> Toilet _ A/C–airhandlingumts � <br /> Balhtub _ Forcedairsystems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace /,1 / <br /> Dishwasher _ Gas range ' � <br /> Clothes washer _ Clothes dryer <br /> Water heater Range hood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> BackOow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF E�'ERETT LOCAL SALES TAX CODE IS 7105 <br /> I hemby certdy Ihal I have read and ezamined this application and know Ihe same to be We and conect. All provisions of laws and <br /> ordinances goveming this type of worh w�ll be complied wdh whether spenfed herein or noL The granting of a permd does not presume <br /> to give a t lo violate rcancel the provision ol any other stale or local law regulating consWction or the periortnance ot <br /> constq�ction.T at I am Ihofized by Ihe owner of this property to perform the work for which app6cation is made and I comply with the <br /> State Contra rs la 8 2712CW and 296200 WAC <br /> � � ...,=� �'\-2,�- \ O <br /> Signature of OwnedContractor/Authonzed Agent Date �I <br /> Z <br />