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` ��RI�lIIT APPLlCA"� �ORI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T& CRE��IT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# P MIT# <br /> /' ,Si Sc 3 /2 90 S 30o y�Ca c� � - ' - - ` � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. � � ��'�� <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �¢� /� ( r;ep-�C LL C /^/o%�,x 9/0 ��?"yy, S'frz3G 3Ga-��/-�F6o'=A� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR I � ��� '���� ��9 -�9.�3 <br /> /^¢lj j�'� �LL� ADDRESS CITY2IP PHONE <br /> ` � <br /> CON R.LICENSE# <br /> �AFKCL �'co /Z �� �/o�-xy�� �� , ���� 3��.��� ���v <br /> USE OF BUILDING I HEAi SOURCE I CONTRACT PRICE C1F WORK <br /> S� — _Electric �Gas_Olher �� UO O <br /> WORKDE CRIPTION ��(,JVf,�f�1G GiQOUN� Rlr¢- <br /> ��� y�� �,�,z«,� �0.�1/CiQ£T� SG/�,(j/Lt/ /NSi/«Tiaifl <br /> PLUMBiNG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYpE OF FIXTURE OR ITEM <br /> 'foll�t� A/C—air handling units <br /> -- -Bethwb � Foccedai�systems <br /> � ---Lavatory(wash basin) '�--Gas piping <br /> Shower _� ater heater <br /> (_ -KRcheq sink&disposal i----Gas ftreplace <br /> _L Dishwasher Ges range- <br /> � Clothas washer -J��-Glolhes dryer. <br /> _ Laundry trey --/--Rangehood_. <br /> Sink(service/bar/mop/etc.) � -Exhaustfaa. <br /> L Backflow preventer Heatpump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> = Floordrein Refrigeretion <br /> _ Grease trep Woodstove <br /> Roof drains Other <br /> Other — -- <br /> ICITY OF EVERETT LOCAL SALES SAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be irue and correct. All provisions of laws and <br /> orainaces goverr,ing this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty :o violate or can:.el the provision of any other state or local law regulating conslructio� or the performance of <br /> construction. T!,at I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> Slate Contr,ac�ors Law 18.27 RC� 296200 WAC. � <br /> ���/�G'��� :Z ��5-v� <br /> Signature of OwnedCohtracrodAuthonzed Agent Date <br />