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- - —, <br /> P�RMIT APPLICATIt,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org j <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED ' <br /> SITE ADDRESS �O S'3� ` �yLe PARCEL TAX I.D.# PERMIT t� I', <br /> �l/�/rr�P° �-f/ Zf� I r'lil Sb7'�� 'I <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. i <br /> OWNER ADDRESS CITY2IP PHONE <br /> �d��`t��-�Lau l����r ���9 � � �zs ���o3z� <br /> �7/ r CUr'E 9BZU 8' <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �1`/G�/��-ozv-�- I �"��{-�il v!�/�ir���rsse��t -�z s: sv8:�'"�S'q- <br /> CONTRACTOR�.;/� �l�C��� ApDRESS CITY2IP PHONE <br /> w�E'_ �C S'�z4 l� fCR.� �rr►�� ={z�so��. <br /> CONTR.LICENSE# SG(l�{�I°fSt��'�' �� qcs�L� <br /> C6� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �Qls� �� _Electric Gas_Other ��d K��� <br /> WORK DESCRIPTION `0)r C.�.�„ <br /> / <br /> f��4 �--. <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet A/C—airhandlingunits <br /> _ Bathlub Forced air systems <br /> _ Lavatory(wash basin) Gas piping S�,� -� <br /> _ Shower Water heater Z,� <br /> _ Kitchen sink&disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Cbthes washer Cbthes dryer <br /> _ Laundry tray Range hood <br /> _ Sink(service/bar/mop/etc.) � Exhaust fan F�if/j�.� �.� ��,� <br /> _ BackFlow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> _ Ftoordrain Refrigeration <br /> _ Grease trap Woodslove /' <br /> _ Roof drains � Other L �K <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby cerilify that I have read and examined this application and know the same to be true and coRect. All provisions of laws and <br /> ordinaces governing this type of work wiil be complied with whether specified herein or not.The granting of a permit does nat presume <br /> to give authority to violate or cancel the provision of any other state or local law reguladng construction or the perfortnance of <br /> construction.That I am authorized by ihe owner of this property to perform the work for which application is made and I comply with the <br /> State ontractors • w 1 .27 RCW and 296 0 W/�C. <br /> rL�� � �� -O.� � z <br /> ignature f OwnedConhactodAu orized Agent Date <br /> Y� So�'U z`I <br />