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� )�: <br /> ;�� . - <br /> - — --------- -- -,i-3-�I <br /> PERMIT APPLICATION "'''' `< _� .,: ' <br /> ' CITYOocEDARS�TREETPERMIT`SERV�ICES °,';,F,,'�AF�oN�� <br /> 425-257-8810— FAX 425-257-8857—www.everetcNa.org <br /> APPLICATIONS A('.E ACCEPTED FROM 8 AM TO 4 PM I <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# , I <br /> 2�3y�s� �� L��.�-� ���� 1 Oo�so��,o6vozoov /C",1��,� � <br /> LEGAL LOTNO. BLOCK TRACT I <br /> DESC. � <br /> � <br /> OWNER ADDRESS CITY2IP PHONE �z� <br /> L�. (( i G�v. ��n d�r�vv�c�v\ -7 Z•3 `-\�`'� s'•'� �u-._:..�� �Zv1 33`i `�`lQ4(�, I <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �'�^ I <br /> ��� �' ' ��'^ �AJ�i�S��'.. 'CiO._ -l4s���� � <br /> CONTRACTOR '�ASN�����`�r» Lv��/r ADORESS �� � � �% JI ° CITY P PHONE <br /> �. l>��� � �`� �� ��;Z� - <br /> �'�z/�iL-� �-7';�l�.r� f7 5'-J7�'� <br /> CONTR.UCENSE It n <br /> CC�f15/�7�k-`i�vUr `J,��� 3Y I <br /> USE OF BUILGING — HEAT:;OURCE I CON�RACT PRICE OF WORK <br /> Electric Gas_Olher I// 7 y y �� <br /> WORK DESCRIPTION I 1 `' • I <br /> C\����i,.F. (,'7"Ci-t � �LtS ��'�.i-p' \�-.�'1"�� I <br /> C�- <br /> PLUMBING MECHANICAL I <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM i <br /> _ Toilet A/C-air handling units I <br /> _ Bathtub Forced air systems <br /> _ Lavalory(wash basin) Gas piping <br /> _ Shower � Water healer I <br /> _ Kilchen sink 8 disposal _ Gas(replace <br /> _ Dishwasher Gas range I <br /> Clothes washer Clolhes dryer <br /> Laundry tray Range nood , <br /> Sink(service/bar/mop/etc.) Exhaust fan I, <br /> _ Backflow preventer _ Heat pump I <br /> _ Urinal Unit heater I I <br /> _ Dnnking Fountain Boiler '�, <br /> Floor drain Refrigeration �� <br /> Grease trap Woodstove , <br /> Roof drains Other i <br /> _ Other — — I <br /> CITY OF EVERETT LOCAL SALES TAX CODF.IS 3105 � <br /> I hereby ceritity that I have read and examined lhis application and know the same to be true and correct. All provisio�is of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein or not The granting of a permit dces not presume <br /> to give aulhority to vinlate or cancei lhe provision ot any other stale or local law regulating conslrudion or the performance of <br /> construction. That I am authorized by the owner of lhis property to perform the work(or which application is made and I comply with the <br /> State Contractors Law 1827 RCW and 296.20�WAC. <br /> ��'� � n.... w�SU� �-� �I 21 �Q Z� <br /> Signature of wnedContractorlAuthorized Agent Date <br />