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PE�MIT APPLICATIO� <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PER IT# — I <br /> IIAIh Ih+� AV� sE l� -lo) _� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> b.,��_. dr�. Developw�e.r�-�- P,o . ��X IoSq Snohoh,�s� WJ�. q62�1 C�Izs) 33�-Sd$ <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �ies DIV1Q1 I �ulldlo. ���G1�� � �i.tP, �-Gi� �(GYI�7cU5 ��ZS� 3�7 '��7 <br /> CONTRACTOR ADDRESS CITY2IP pHONE <br /> ��,�� l,Jes� C�rp. (?o, c�X 3S3S Ar1�n5}�n�Wi�,`�8223 ��lzs)2ho-�1 <br /> CONTR.LICENSE# <br /> _ ���e�'t,1� I 87 k,�� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other I Zc��ac'�b <br /> WORK DESCRIPTION <br /> T��,��,+ I�hP;,�z��,� <br /> PLUMBING MECHANI�AL <br /> N�• TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 3 Toilet A/C—airhandlingunits <br /> Bathtub Forced air systems <br /> �'� Lavatory(wash basin) Gas i in <br /> PP 9 <br /> Shower � Water heater <br /> _ itchen s;nk& disposal Gas fireplace <br /> = D washer Gas range <br /> Cioth washer Clothes Cryer <br /> Laundry tr Y� nge hood <br /> � Sink(service/b m /etc.) Ex ust fan . <br /> _ Backflow preven Heat mp=� � <br /> _ Urinal �_ Unit h r <br /> _ Drinking Fo tain Bo' r <br /> _ Floor dr ' frigeration <br /> _ Grea trap Woodstove <br /> _ R drains Other <br /> ther — <br /> I — <br /> ICITY OF EVERETT LOCAL SALES SAX C�DE IS 3105 <br /> � I hereby ceritify that I have read and examined this application and know the same to be true and correct. AII provisions of laws and <br /> I ordinaces yoveming this type of work will be complied with wiiether specified herein ur not.The granting of a permit does not presume <br /> ! to give authoriry to violate or cancel the provision of any other state or local law regulating construcBon or the performance of <br /> construction. That I am authorized by the owner of this property to perform the work for which application is made and I wmply with the <br /> � State Contrectors Law 18.27 RCW and 296.2C0 WAC. <br /> � • � ��Q�/D�} <br /> ' ��,, ,._ ni <br /> i Signan�re of OwnedConta dAuthonzed Agent Da��— 1/� <br />