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F�cRMIT APPLICATI�N <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 PARCEL TAX I.D.8 PE IT# <br /> iG 2� ca i,{�,,,,a sf F��� 93z � 09/2 0l�' <br /> LEGAL LOT NO. BLOCK TRACTOR SUBDIVISION ll <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE y q�1 ti <br /> C�� o� �ve,retf 293v �tf�+te+'e Q✓e. �vu-e{f, 9B2o/ 4Z5 2s7•8996 <br /> TENA T NAME CONTACT FOR PERMIT PHONE ¢Z$ Z59-3 I G I <br /> �/A I K��/O�N�/O�IGS E�l11AIL O�H � 4N.NG <br /> L2SN-TR�C T A66AE$$ /� <br /> CONTR.LICENSE N / 1��'� <br /> USE OF BUILDING I HEAT SOURCE CONTRAC7 PR�CE OF WORK <br /> 1 HElepiric 1 Gas_otner �d C� #�490�OdO, °-'- <br /> WORKDESCRIPTION $u�ldi �nv�loP� ctnd ti(tctian��a�, �le��lri�al and �ruc�w<( <br /> clP9�s. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> (�;`foilel A1C-air handling units <br /> � Balhtub _ ed air syslems <br /> � Lavalory(wash basin) � � _ Gas iping <br /> Shower _ Wal rhealer <br /> Kilchen sink 8 disposal � _ Gas fireplace <br /> Dishwasher _ Ga range <br /> Clothes wa r _ CI thes dryer <br /> r ealer nge hood <br /> Sink(service/barlmop elc.) � haust fan <br /> { Backflow preventer � H t pump -Mi4Su6iSH� <br /> i Urinal _ Uni ter <br /> � Drinkinc�Founlain _ Boiler <br /> � Floor drain _ Re(rigeration <br /> Grease lrap Waodslove <br /> 5 Roof drains � Olher It�kriL �a' <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 7105 <br /> I hereby cerilify thal I have read and ezamined this application and know the same lo be true and cortect. All provisions oi laws and <br /> ordinaces governing lhis type of work will be complied wilh whelher specified horein or not.The granting of a permit does not presume <br /> to�ive authoriry lo violale or cancel the provision of any olher state or Iocai law regulating construction or tho periormance of <br /> conslruclion.That I am aulhorized by lhe owner oi lhis propeAy lo peAorm lhe work tor which applicalion is made and I comply with the <br /> State Con a tors Law 1927 RCW and 29G200 WAC. <br /> I2 7 7•0o b� <br /> Sig Wre O nedC traclodAuthorized Agent D te r)rn <br /> /c,�lC <br />