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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 <br />SITE ADDRESS <br />� fIy%t '<� PARCEL'rAX I.D. k P RMI <br />1loG,ii'TF�rT�rv"� - <br />2�oh �ooc��flG�2 <br />�oo ER of o7 <br />LEGAL LOT NO. BLOCK TRACTOR SUBDIVISION # 5 -,^ VA <br />DESC. j S" %, 5E%A 5F(- 30� T�VP, 28N 1 C11— VV,i <br />Dune[ <br />rI:EO /i1ti�°I 1, STOF � • INC, lgoo 5f ';2-ApMeI F ILTLAN P 09- 503 �`i j 35GY1, <br />TENANT NAME CONTAC r FOR PERMIT /� PHONE <br />D lVl I h1AI-C `JtiUUFELA E-MAIL 11L-`.� f <br />--ADDRESS CITYIZIPm1V <br />65 <br />CONTR. LICENSE N <br />USE OF BUILDING O T HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric _✓ Gas_.Olher 1-3 AK-00N <br />WORK DESCRIPTION u �� <br />�e�u rovetrin wl c� v�eu9cr�vE.-t�lr�t <br />P f^av Knn ccwor OVIV4 - P, cov-eU k p laVV'I,,l. <br />PLUMBING MECHANICAL <br />NO, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toiler __ A%C - air handling units <br />_ Bathtub _ _ Forced air systems <br />Lavatory (wash basin) _ Gas piping <br />_ Shower Water heater <br />_ Kitchen sink 8 disposal _Gas fireplace� <br />Dishwasher Gas <br />Clothes washer Clothes dryer . <br />Water heater Range hood � <br />Sink (service/bar/mop/etc.) — Exhaust fan 3� <br />_ Backflow preventer Heat pump <br />il healer <br />Urinal Boiler <br />Drinking Fountain __ Bo <br />F_ Refrigeration <br />Floor drain <br />_ Grease trap _ Other ove <br />Root drains Other <br />-- Other -- -- -- — <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31W <br />1 hereby ceriti(y that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am au ri4bythwner of this property to perform the work for which application is made and I comply with the <br />State Co tors La .27R6.200WAC. <br />_Signature of Owne 'Contr oAgent Date i <br />�[L <br />