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.;,Lt" � '�{ <br /> . . ,:i rEt�i ';i <br /> a ;I <br /> P'�RMIT AI'PLICATIC,�� �� ����`:`�'�'�,� � � <br /> CITY OF EVERETT PERMIT SERVICE� ,���f 'i' <br /> �� � b lt� �r�� <br /> 3200 CEDAR STREET, FVERETT, WA 98201 ';;��y;�,;�:<;;i!is�' ``t <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org � � '' '� <br /> .�E��: <br /> , � � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARa:i ARE NOT ACCEPTED � " <br /> � i <br /> [ �� ��, i <br /> SITE ADDRESS PARCEL TAX I.D.# I PERMIT# � <br /> ` n a G �- 7 <br /> � / T �.. <br /> / — �� �� � t �� <br /> LEGAL LOT NO. BLOCK TRAGT "�� �` i'� * ' <br /> DESC. .._. ��C-J �-X�� -���}CJ �' `��j�. <br /> OWNER �l ADDRESS � I . �� . <br /> � �, � CITY2IP PHONE <br /> � �L�� �2_� C�SO�.� I`�0� ��c�� ��t �`�'e���� � ��� � �� ,�� '� <br /> 4� <br /> TENA T NAME CONTACT FOR PERMIT PHONE �� ����1�. <br /> ...��,F�;. '�.r'� <br /> CONTRACTOR L \ ���\(�C�ADDRESS �'�� I�` '� '� 21P PHONE �(,,,0 —' �) '.�'r�F , '..�. �, ,. <br /> CONTR. LICENSE# � LE�� �1 O I V ` � ��, ���1 V J^� -�S�(J <br /> >.,, < <br /> . r <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK � ; , ��" <br /> Electric Gas Olher a �'1 �" { <br /> � :�s � ? <br /> WORKDESCRIPTION ��`''S�� � �� <br /> ,� <br /> m <br /> 5� G��A <br /> t� ",-5" <br /> t;�t:ywt�� , <br /> �-� <br /> S.t`fy <br /> 1?`�'1`t{ . <br /> PLUMBING MECHANICAL '�;�,�"�``'"�A <br /> � r v; <br /> � N�t� .�AK ... . <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM 4 �,� r Yy "`'� � <br /> _ Toilet A/C-air handling units I *' f�������'�;: <br /> _ Bathlub Forced air systems � '� ' <br /> _ Lavatory(wash basin) Gas i in ' `����' <br /> Shower -- �P � �`� � � <br /> — Waterheater ' , ? <br /> _ Kilchen sink&disposal _ Gas(ireplace 4� ,, <br /> _ Dishwasher Cas ranc�e F `�' <br /> _ Clolhes washer Clothes dryer ~ x � ' <br /> _ Laundry tray Ranc�e hood � rrr�';' „�-0 <br /> Sink(service/badmopielc.) Exhaust(an � Y� p� �` ' <br /> _ Backflowpreventer Heat um w< <br /> P P <br /> _ Urinal Unitheater � ;'=; <br /> Drinkinc� Fountain Boiler , 1 <br /> _ Floor drain Refrigeration <br /> � _ Grease Irap _ Woods'ove � <br /> Roof drains Other <br /> Other — <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 9105 <br /> I hereby ceritify lhat I have read and er.amined this application and know the same lo be true 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 give aulhority to violate or cancel the provision of any olher state or local law regulatlng construction or lhe performance of <br /> c9nstruclion.T!�at I am authorized by lhe owner of this property to perform the work for which applicalion is made and I comply with the <br /> St te Conlractors L�,v 18.77-RCW alid 296.200 WAC. <br /> � <br /> ,���� .< � � � ��1�^. J � � )�� <br /> Sign ture Owner Contractor thonzed Agenl Date <br /> J <br /> �.,�'`� '� <br />