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� P�RMIT APPLICATIO�N <br /> CITY OF EVERET i 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 <br /> SITE ADDRE�S PARCEL TAX I.D.# OD44�j-oCb'A60• ER IT# <br /> 2oy y8t� S�• S.u). fVEaEtr (0 7 7 � �-�OS- �-3 <br /> LEGAL LOTNq. BLOCK TRACT ` � <br /> oesc. (00 FC�R�ST PARK ADOIT�OI�) °TD EJER�jr �1�/ A <br /> OWNER ADDRESS CITY2IP PHONE <br /> SCo'�i' 'r C tNDY ff o1.KGRtqI Zr�9 - 4Bt" sr S.u1. f�tRETT ��25� y2g • 000a <br /> 48203 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> SC�f �-ci�rX N-o�+�6 �N I Scotf F}o�.+�tGRb�) 425 - qt3 � Oaco <br /> CONTRACTOR �WNL` ADDRESS CITY2fP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING I HEAT SOURCE r1 p�.1� CO�TRACT PRICE OF WORK <br /> GhIIAGE n ,��(� A. <br /> I _Electric _Gas_Other <br /> WORK DESCRIPTION <br /> 3g'x 2� ' GARAG� <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FU(TURE OP,ITEM <br /> Toilet A/C—air handling unils <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(service/bar/mop/etc.) Exhaust far� <br /> BackFlow prevenler Fleat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> _ NOAJ� _ N�NLr — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify that I have read and examined lhis applicalion and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not.The granting ot a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construclion or the performance of <br /> construction.That I am aulhorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> iJoalure of OwnedConlraclodF ulhorized Agenl Date <br /> �I <br />