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P�� .MIT APPLICATI�.�� <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 /a —g�S <br /> SITE ADDR SS � PARCEL TAX I.D.p � PERMIT N <br /> �- � 7 S�.o,�z +�r.,�e_. � - <br /> LEGA LOTNO. BLOCK 7RACT ,� ^ r' 1 <br /> DESC. ' " ��i.v-Q.. Ci^ +��X .I'.Un �O �U1^e..�� <br /> OWNER ADDRESS CITY2IP PHONE <br /> 3��I�'��,r�. S«w� , u z5�'>u �!!� <br /> TENANT NAME � CONTACT FOR PERMIT PHONE <br /> NO�� �r �LP TY`�l�ll� <br /> CONTRACTOR �SG��` tl� N,� v� ADDRESS CITY2IP PHONE <br /> �iJl�c�x �) Z3 St-�..W���) `tZ5�3� `i 7 >B� <br /> CONTR.LICENSEp �_,O��C '�1�' ���1M11 1 �ISZZ�Z <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> `_>� � I _Eledric �Gas_Other I ��� IL�C�� <br /> WORK DESC�PTION �,^/ � <br /> �l��,l;�-�u�� '1"� L:., :...a - 3e(+� rJ�,�s <br /> ��..,. � S'�.� ��c��rJ:�+'^ '� �2{�✓�J.H` <br /> �K c-�i <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> � Toilet A/C-airhandlingunits <br /> 1 �alhtub Forced air systems <br /> �— Lavatory(wash basin) � Gas piping <br /> i Shower Waterhealer <br /> Kilchen sink 8 disposal 1 Gas fireplace <br /> Dishwashcr Gacrange <br /> Clolhes washer Clothes dryer <br /> _ Laundry tray Rango hood <br /> Sink(servicelbarhnoplelc.) � Exhaust fan <br /> 8ack(low prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease Irap Woodslove <br /> Roo(drains Olher <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 1705 <br /> I hereby ceriti(y thal I have read and azamined this application and know lhe same ro be lrue and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> to c�ivo authority to violate or cance�the provision of any other slate cr local law regulating construction or the peAortnance of <br /> constmction.That I am auU�orized by the owner ol Ihis property lo peAorm tha work for which application is made and I comply with lhe <br /> Stale Conlraclors Law 18.27 RCW an ?��J6.200 WAC. <br /> �f�- ..�� � � � �� ���vs <br /> SignaWre o OwnedContractor/Authorized Agent Dale <br /> ��1 <br />