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PE�rtMIT APPLICATIOI�r <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 9 —a U�U <br /> SITE ADDRESS ' / _ PARCEL TAX I.D.N PERMIT N <br /> 1 /(� w,7� 00�-I 1 3 .00�o - ooc. <br /> IEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> ER ADDRESS CITV2IP PHONE <br /> 4��ck Lap�nsk� �o Bo,r � 4�$ �v,��ett 48ao� yas-�o-���3 <br /> TENANT NAME CONTACT FOR PERMIT PMONE (�fj.3�'I•9 b64 <br /> SC.RU4iS �� �� Il��.L� So�mTccPevi�v� 5u4bm�eL ybssPorFsqr; p. <br /> C��,Jv1�PX-� Wes�S;�e ��e� Sa.�'<�y PO.(3oX "l �2 m�wl 9$�7p <br /> CONTR.LICENSEM`- '��s�S ��OSL � ���-qy1 - 530g <br /> W <br /> USE OF BUIIDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> 'Q6S'�"aVru�n'�� Bo.�c' a �a7 <br /> Electric �Gas_Other �5�� <br /> WORKDESCRIPTION r,1�,G C <br /> �'" `'�•PPcess; ov� Sys-f�,m <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC–air handling units <br /> Balhtub Forced air syslems <br /> Lavatory(v+ash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher _ Gas range <br /> Clolhes washer Clothes dryer <br /> Water heater g Range hood <br /> Sink(servicelbailmop/elc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease irap _ Woodslove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby certi(y that I have read and examined this application and know ihe same to be true and corted. All provisions o(laws and <br /> ordinances governing this type oi work will be complied with whelher specified herein or not.The granting of a permil does nol presume <br /> to give authority to violate or cancel Ihe provision of any olher state or local law regulating consirudion or the petformance o( <br /> construction.That I am authorized by the owner of this property to perform ihe work for which appticalion is made and 1 comply with Ihe <br /> Stale Contractors Law 18.27 RCW and 296.200 WAC. <br /> D �._._..��.��-��t -o?�''-�D <br /> re of OwnedConiractor/Auth ed Ag Cate l <br /> � /Z <br />