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May 18 06 08: 33a Srntt King 3606688809 p. 2 <br /> PERMIT APPLICATION <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.# P RMI <br /> / (0z9 ia-7 iPf4 sE 1 + CfT#0s - (7 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> C11,,`s C,i SIL / (Q 2-9 t 27 -- 0 ICc c,e <br /> b <br /> PHONE <br /> TENANT NAME CONTACT FOR PERMIT !✓'r .0".0" f c <br /> c_.0-tf- i'-< CITY/ZIP 1 PHONES 71^M� <br /> CONTRACTOR •GO71 '< / ADDRESS <br /> -?O (363x ((I GL.)ood;wi;/(e `y25 311.-8 <br /> CONTR UCENSE# 5C-0PKC O O 3 Ol'-jG <br /> - -sI -0 L- <br /> USE OF BUILDING HEAT SOURCE CONTRACT:PRICE OF WORK <br /> iee ' r).,_, _Electric Gas Other I e <br /> WORK DESCRIPTION <br /> Re,,,,,,,i, .4„,_---?(R.wib-7-,-,6) / I v.1 i'vl <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 1 Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> I Lavatory(wash basin) Gas piping <br /> I Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> __ Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces 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 state 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 /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> Signature of Owner/Contractor/Au :rized Agent Date <br />