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_ ; -- <br /> PERMIT APPL�C,ATION <br /> CITY 4F EVERETT PERMIY SERVICES ;; ~L� �'�� � � <br /> 3200 CEDAR STRE�T, �VERETT, WA 98201 ;�✓-� ^r <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org ��,.5 I`��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 6\/ Z D� <br /> SITE ADDRESS PARCEL TAX I.D.# PEHMIT# <br /> ��SE UNiT a D �7H��O101�ob1 I �3n.���� �C��� <br /> LEGA LOT'!O. BLOCK TRACT OR SUBDIVISION It <br /> DESC. <br /> OWNER AUDRESS CITY2IP PHONE <br /> rVlbrint,r S�,vare )nves+mer�}s Po Pax 105� �nahor�ish 982q1 <br /> TENA� CONTACTFORPERMIT PHONE � �2—"7'�2J8 <br /> �YviGc�l� • I MAr'G LAW�L'✓lCe • e-�,�a�me�G@wacs�x�rnean. <br /> wFs�,.► NF� 2700 �ST� S. �� 98�3�/ 2� �z-��38. <br /> CONTR.LICENSEp ��S��N��99oE - <br /> USE OF BUILDING HEAT SOURCE CONTRACT P E OF WORK <br /> _Eleclric _Gas_Other i J�x�� % <br /> WORK DESCP.IPTION � <br /> /A/S� �X SlNI�LE FiP-GEI� �v� u��`i-r.L S/!�,/�/S <br /> � ����� NG c�J Ba�ez�� 'rU3i�G, . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. � TYPE OF FI%TUR[OR ITEM <br /> Toilet _ A/C—air handling units <br /> Ba�htub rorced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink&disposal _ Gas lireplace <br /> Dishwasher _ Gas range <br /> C'othes washer _ Clolhes dryer <br /> Water heater __ Range hood <br /> Sink(servicelbar/mop/e�c.) _ Ezhaust tan <br /> Backflow prevenler _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain _ Re(rigeration <br /> Grease trap _ Woodstove <br /> Root drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i hereby ceritify ihat I have read and examined this application and know the same to be Uue and correct. All provisions ot laws and <br /> ordinaces goveming this type of work will be complied with whether specitied herein or not.Th,granting o(a permil dces not presume <br /> to give authority to violate or cancel the provision ot any olher state or local law regulating con,;truction or the periormance of <br /> construclion.That I am authorized by ttie owner of ihis property to perform the work for which:ipplication is made and I comply wilh the <br /> State Coniractors Law 18.27 RCW and 296200 WAC. <br /> �:�. y �/�� . <br /> �2„ _� <br /> Signalure ol O ne on!raclor/Authonzed Agent Date� / <br /> � (� <br />