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� t <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 4?5-257-8810—FAX 425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� "�� —�� <br /> SITE ADDRESS PARCEL TAX I.D.X PERMIT k <br /> ioz�� ia-u, �v�� MIc� U . olv <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION• <br /> �ESC. <br /> OWNER ADURES5 CI7YZP PHONE <br /> Jp Mov�ctrl G�c�sc. 13ot Zhd ltvt,� I'�-1�h FI� ScaH�lc,q4(UZ 20(0-23�-35� <br /> TENANTNAME CONTACTFORPERMIT PHONE 25$-(p3p-(pq$3 <br /> Jp vnor�ct.v� G�4SG I �c�Gvk' S11A� <br /> e�a�robc��.s�,aw���tal iwl. <br /> � co.�, <br /> V�kRI Met.haniser�ice 131o� 5E24W1,5t,s+etoi Kcht�,9&�31 253-�¢3�-�o�G33 <br /> CONTR.LICENSE/ VITA'l-t�-�SollQ�-kMM <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WOF!K <br /> ✓Electric _Gas Other '� �-OZ-O O <br /> WORK DESCRIPTION <br /> 1�1s1-G�ll alALl-LLSS Spli-F s�(5-FC�'v� F't�r -`-1�t �;-Cl�t�r ltnt btH.�hd 812C-; . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. iYPE OF FIXTURE OR ITEM <br /> Toilet � AIC-air handling units !•S }o h u�+1i-. <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Waterheater Range hood <br /> Sink(service/bar/mopletc.) Erhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeraticn <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and corted. AI�provisions of laws and <br /> ordinances governing lhis type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel lhe provision of any other stale or local law regulaGng consWction or the pedortnance of <br /> construction.That I am authorized by the owner of this property to prriorm ihe work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> ��liy�,1 �d-1 P.Gi�l�t�� � �I �.Z �/rn <br /> Si ure of OwnerlCBntractodAu honzed A ent at � <br /> 1.' <br />