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P��IMIT APPLICATI�� <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 - DEBR 3 CREDR CARDS ARE NOT ACCEPTED <br /> PARCEL TAX I.D.A E�rc� <br /> s�noo�ss�� .� �gth ��t s E ��� a'3 <br /> � <br /> LEGA LOTNO. BLOCK TRACT � � <br /> DESC. <br /> OWNER f, � A�DRE S <br /> ..p{��n�cy ��S���l�►o r� 173aZ1 � <br /> I CONTACTFORPERMR PHONE � <br /> TENANTNAME d <br /> p�gg CITY2IP PHONE 3 <br /> CONTRACTOR u�' ��q,'� d- ��y�Q ��C <br /> i,vo�Fe �'= 033c�' �? 3e21 T'�l S'T-i�'$ �Q�79Y'8'6'�� � <br /> CONTR.LICENSE A�. r✓Ian J�o e , t�v/9 Q goZ 7-Z <br /> HEAT SOURCE CGNTRACT PRICE OF WORK ; <br /> USE OF BUILDING � <br /> 0 C�S e _Electric _Gas_�er <br /> WORK DESCRIPTION � <br /> � 3 p S�;r k I�e�- Sys�m :� <br /> � <br /> PLUMBING MECHANICAL <br /> NO. <br /> TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM� <br /> AIC–air handling uNb i <br /> Toilet Forced air syetems <br /> ���b Gas pipiny <br /> — lyvatory(wash basin) — yya�r heater <br /> Shower — Gas flreplace <br /> IGtchen sink 8 disposal — Gas range <br /> Dishwasher Cbthes dryer <br /> Clothes washer '— ��ge hood <br /> _ Laundry tray — �aust fan <br /> Sink(servicelbar/mopletc.) — Heat pump <br /> — Backflow preventer — Unit heater <br /> Urinal — Boiler <br /> Drinking Fountain '— Rg{�geratlon <br /> Floor drain — yyp�gWve <br /> Grease trap — Other <br /> _,� Roof drains3 O CI��/e�• Sy��\ <br /> Other � — <br /> C�TY OF EVERETT LOCAL SALES SAX CODE IS 7105 <br /> I hereby ceritliy that i have read and e�camined this applicatlon and know the same to betrue and correct• PJI proviebns of lews and <br /> ordinaces goveming this type of work will be complied with whether specfied herefn or not The grentlng af a permit doea not preaume <br /> to give authority to violate or cancel the provision of any other state or local law regulatlng constructlon or the perFortnance of <br /> consWction.That I am authorized by the owner of this property to perform the work forwhich appllcatlon is made and I comply with the <br /> Slate ConVact La 18.27 RCW a 296.200 WAC. <br /> I ontra od nt ate �L <br /> Signature a <br />