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,� <br /> PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SEP:�/iC;ES <br /> 3200 CEDAR STREET, EVERETT,WA 9<<20� <br /> 425-257-8810—FAX�',25-257-8857—wuwi.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE33 ` � S� PARCEL TAR I.D.# PERMIT 11 �J L <br /> � I �l I `� I 1 c`�� '� �;C / <br /> LEGA LOTNO. BLOCK TRACT � <br /> DESC. <br /> ADDRES8 CITY/7JP `��SNE'33L� - SZJIS� <br /> n� ,��fc� e ��—nrcl ;hi I��v�lc�_ if 1"c !�-X ICS"0� S��Dl�c,�+ 5a wr� ��8:�( I <br /> ��_3f d --r <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Cut� � f-s D<< L-t rc�u�K� I K�..H H�,,,� �/— 4z 5^ 7 �C -�'s'3S— <br /> CONTRACTOR {��,rf't : �t'�t ' ADDRESST`/�'�� �����czsoiicinmal,�4���ONEG�✓LS�7��— ��. <br /> 4335r � <br /> CONTR.LICENSEt Y, ^ ! v ( 2 I <br /> J[ J��l. <br /> USE OF BUILDING / HEAT SOURCE I CONTRACT PRICE OF WORK i <br /> Pl��Electdc _Gas_Other 5� �/�f� �'= ,I� <br /> �C - i':" , H �� t� <br /> WORK DE3CRIPTION I.��5��.i r 1 �— � � �`^ �� �"�n`t S ' `� '� •��G�« �t�L c� ��P.�'� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet _ aC—air handling unils <br /> Bathtub _ Forced air syatams <br /> _ Levatory(wash besin) _ Gas plping <br /> Showar _ Weter heater <br /> Kilchen sink&disposal _ Gas fireplace � <br /> � Dishwasher _ Ges renge <br /> Clothes washer _ Clothes dryer <br /> Laundry Uay _ Range hood <br /> Sink(servicelbar/mopletc.) _ Exheust tan <br /> Beckflow preventer _ Heat pump <br /> Urinei _ Unit heater <br /> Drinkln8 Fountain _ Boller <br /> Floordraln _ ReMgeration <br /> Greesa trap _ Waodstove <br /> i _ Roofdralns = Other <br /> Other <br /> CITY OF EVERETT LOCAL SALE9 TAX CODE IS 3106 '��. <br /> I hereby ceritify that I have read end exemined this appllcalion and know the seme lo be true and correct. All provislons of lews and <br /> ordineces governing this rype of work will be complied wilh whether specifled hereln or not The grenling of e permit does not preaume <br /> to glve authorjry to Ioiale or cancel the provision of any other slate or local lew reguleUng constructlon or the perfortnance of <br /> construction.�That� m euthwized by lhe owner of this proparry to pedortn the work for which epplicatlon Is mede end I comply with the <br /> State Cont�3ctor�L w 18.27 RCW end 296.200 WAC. `'^ � / <br /> ' �� �t'� �' � � � � � . <br /> gnatu7e p wn r n fec or ut onze gent 1e <br /> I <br /> l� Z <br />