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PERMIT APPLICATION <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 /> NPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS I 03 3 3 ��� A.r�- S L" PARCEL TAX I.D.# PERMIT# <br /> c�c�c�; w4 �g�og OOS �S 5p0000t�oo t qon /iI 7/� �{� <br /> LEGAL LOT NO. BLOCK TRACT , <br /> oesc. (o �7 � f �1 vu� g S�Iv�r �.a.K�. U��ei � �i-o-cfis <br /> OWNER p,p, (SoX �Ao'i.bg � M�l� Crc.er7�1'�C.�i! PHONE N�R <br /> F✓�AP LLC q5fvk2 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> N w A s�.�a : An e� �� sesse r�n�z. �Zo�) �wSS - �/a8 S <br /> CONTRACTOR ADDRESS CITYIZIP PHONE <br /> Mc,.c,1.�no..la C�+.�ll -t! -1'1� '1 17ekvn'�t A�R S �--� ��oG)�7(oSl - �faZ$ <br /> CONTR.LICENSEi S2�"�"�' 1 �"�A q�/O�a <br /> Yu1�4CJOO�S 9$OGZU 12 -3/-O'l <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �_Electric _Gas_Other '� l) L���' <br /> -._/�._... <br /> WORK DESCRIPTION <br /> � i' <br /> � �i�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURF.Oe�ITEM <br /> Toilet A/C-air handling units <br /> 6athtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kilchen sink 8 disposal Gas freplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhausl fan <br /> Backflow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 9705 <br /> I hereby cerilify Uiat I have read and examined this applicalion and know the same lo be lrue and correcL All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whelher specifed herein or noL The granting of a permit does not presuma <br /> to give authority to violate or cancel lhe provision of any other state or local law regulating consiruclion or the p=Aortnance of <br /> construction. That I am authorized by ihe owner of ihis property to perierm the work for v:hich appliwtion is made and I comply with the <br /> tate !r-ac ors Law 18.27 RCW a�` 6200 WAC. <br /> � �''�-��"\�J� 1 u- I I —��7 <br /> —6i3rie�t wnedConlrador/Autho gent Date �, <br /> ���, <br />