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' � <br /> � <br /> P��10'i1T APPLICATIO�I �9�iD <br /> CITY OF EVERETT PERMIT SERVICES � , <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-25i-8857—www.everettwa.org ����� - ��j <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /���,%1.��(fi <br /> SITE ADDRESS PARCEL TAX I.D.# RMIT# <br /> �� 1 <br /> ,53o� 23R0 c� w�fi, E✓��<�r 2So9oGoa2oay0o _ -- <br /> LEGAL LOT N0. BIOCK TRAC7 OR SUBDIVISION# � <br /> DESC. <br /> OWNER ADDRESS � CITY2IP PHONE <br /> ,SEAI✓Ay CORPr�RA1E LVT 3C LLC �/q,�2 NE 971N,fiis'�Er SEAl1l..` vA 9B/iS <br /> TENANTNAME CONTACTFORPERMIT PHONE y1S�9�3_S6S7 <br /> �✓6S h�/���dn Ar/�Oo�4�r� %3�� ( �pnu�l/�4n Mf�ir�n e-Ma� Jm i l�an�'ad✓Fiie,ne�- <br /> �� $ 1T4P11P-- <br /> Ad✓Gn«d F�e P�ulecle„ � v. 6ox iS43 �C�oo��nv�l� wA Jl5)4I3-365� <br /> CONTR.LICENSE# �v�A�/f����t��G , `�UOJL <br /> USE OF BUILDING HFAT SOURCE CONTRACT PRICE OF WORK <br /> U"��e _Electric _Gas_Olher � 7Od d <br /> W ORK DESCRIPTION <br /> �S�cl� �7N41 'Z" .S�r'�Klr� /y1G�/1 G✓/ah l'/y� q, ��� �i�eS �a <br /> �o�ec� �e[�l c'e� l�n�5 Gnd [J4lls, �vev Z'• �5�(�ply is 4�e �nfe c.� rx�s���S <br /> we< ,yra�,�Kirr sy��cin. o?G> Ina�J > ) <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FxTURE OR ITEM <br /> Toilet PJC—air handling unils <br /> Balhlub Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kilchen sink 8 disposal _ Gas firepiace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(servicelbar/mop/etc.) _ Exhaust fan <br /> Backilow prevenfer _ Heat pump <br /> Urinal Unil heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Rafrigeration <br /> Grease trap _ WooGstove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritity that I have read and examined this applicalion and know the same to be true and correcl. A�provisions of laws and <br /> ordinaces goveming this lype of work will be complied with whether specifled herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other slale or local law regulating construction or the perfortnance of <br /> construction.That I am authorized by lhe owner of this property to periorm the work for which application is made and I comply with the <br /> State Contra�ctors Law 18.27 RCW and 296.200 WAC. <br /> �/4na�h4.i /�i l�'un Or/3-/r7 <br /> Signatur of OwnedContrar,todAulhorized Agenl Date <br /> ''Z <br />