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P'�RMIT APPLICATI�. .+I <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 /> APPLICATIOhS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE hIOT ACCEPTED <br /> SITE ADDRESS ����� PARCEL TAX I.D.# PERyIIT# � <br /> / �{ l " _ Iccl3 OO�)`f706tO11�0 � I ��/� ` <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> � f1'1p�1 ����Qv�t' ' 11JUc,ST�1Ct�iT1.�L � t�X ros9 .cno�-� 9��q! �I�' S3N .SO1R <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRpACTOR ADDRESS CITY2IP PHONE <br /> JV�F—Tl'� llJ eJS\ ��J tv� t`�J <br /> CONTR.LICENSE# <br /> .���rsn �c-K c3 �'� I i� ��b�(� �P 1 I�i r �� 9'8LL3 36a C�s3 �aa�\ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> 1wc �e.SC ''�ootMs � v�� S,�o(Z 'T"S-- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �,� Toiiet A/C—air handling units <br /> Bathtub Forced air systems <br /> � Lavatory(�.vash basin) Gas piping <br /> Shower �, Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> L2undry trey Range hood <br /> � Sink(serv:ce/bar/mopletc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeretion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Olher <br /> I — — <br /> ICITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I <br /> I hereby ceritify that I have read and examined this applicetion and know the same to be lrue and correct. All provisions of Iaws and <br /> ' ordinaces governing this type of work�.vill be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel the provision of any other state or local law regulating construction or the peiiormance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with tha <br /> , State Contractors Law 1827 RCW and 296.200 WAC. <br /> I /� ����i� S /� 6 -0�-( <br /> , Sign ture of OwnedConlrector! uthonzed Agent Dale <br />