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Jul 09 04 02: 51p RRCp RRCHITECTURE 2066221117 p• 1 <br /> ( <br /> PERMIT APPLICATION <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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADORESS PARCEL TAX I.D.# PE��T� <br /> Itfpb�' t9T�! /svE � z � 2go5- 2•oi . eu�oo ofb•ncb 07- 3 <br /> LEGA LOTNO. BLOCK TRACT <br /> oEs�. �o,rr, ,A 5Ec • �e,►r+�t�.5 . �rbw N�rfi p z$• <br /> OWNER RE55 GITY2IP PHONE <br /> �E�I`��lP�� " �i•C � s I�dJ� �oW �T �•olo . foZ2 � ao5a1 • <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> v�A-r�Hr'• ���c, ov�rs�r� Zo b• 8345• 1�- <br /> CONTRACTOR �r7N,�W�-f.7� , AODRESS CITY2IP PXONE <br /> V J u. <br /> CONTR.UCENSEp JYNE+WGI IL� LG �I'Q,� "/OZ� , �YHN'r►�wl� �b �j1.� h4�4, <br /> USE OF BUILDING �P����US I HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��1�}�� _Eledric _.Gas_Other <br /> WORK DESCRIPTION ��tj" �jU IL.O I NCJ <br /> R��rr�- c� SMn�►�i- � uH if dr z <br /> Rtrnov�rs�. o� M�t�ti�t I�oM� d� �[�nn-�� P�U1�1�+6 , . <br /> PLUMBING MECHANICAL <br /> NO: TYPE OF FIXTURE OR ITEM NO. T'FE OF FIXTURE OR IfEM <br /> Toilet _ AIC—airhandlingunits <br /> Balhlub _ Forced air systems <br /> Lavatory(wash basi�) _ Gas piping <br /> Shower _ Watorhoater <br /> Kitchen sink 8 disposal � _ Gas fireplace <br /> �ishwasher _ Gas range I <br /> Clothes washer _ Clothes dryer <br /> _ Laundry tray _, Range hood <br /> Exhaust fan , <br /> _ Sink(servicelbarlmop/elc.) — Heat pump �a'' <br /> Backflow preventer — <br /> Urinal �� ,_ Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floor d2in Refrigeration <br /> Grease trap ,_ Woodswve <br /> Roof d2ins _ Olher <br /> Other — <br /> � — <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritify that 1 have read and examined this application and know ihe same to be trua and correct. All prov(sions of lawa and <br /> ordinaces governing this rype of work wlll be complletl with whethar specified herein or not.The granUng af a permit does nol presume <br /> ta giv authority to violate or cancel�e provision of any other state or local law regulating co�strudion w the perfortnance of ��h the <br /> cons c'Jon.That I am authorized b the owner of this property to perform the work for whlch application is made and I compiy <br /> State C ctors Law 18.27 RCW and 296.200 WAC. �b y�� Q�, <br /> . <br /> SignaWre of OwnerlConUactodAuthorize0 Agenl Date <br /> ALAT1 �. ��6� �'1�1 . <br />