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PERMIT APPLICATION <br />CITY OF EVERETT QERMIT SERVICES <br />3200 CEDAR STREET, E'JERET", WA 98201 <br />425-257-8810 -• rAX 425-257-8857 — www.everettwa.org <br />t�6�%�-�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. il PERMIT # <br />9505- 19TMAVE.S.E.,S��r� �r4 Zio517-003 -053��0o I�-05o3—oe9- <br />LOT N0. � BIOCK I TRACT <br />DESC. <br />TENAN7NAME <br />DR. ETEMAoI <br />CONTRACTOR <br />MF�Zi'r M�GhfAf�ICAL�I�IG <br />CONTR LICENSE i <br />USE OF BUILDING <br />ICONTACT�ORPERMiT <br />ADDRESS CITY2IP <br />�J�o3o 15�R0AVE, PI,E. t2Efl �o� <br />!�vEiZETT �oi7�89� � � <br />HEAT SOUF:CE <br />Electric Gas <br />Other <br />PHONE <br />PNONE <br />425 •Ss+!•9Ti14 <br />CONTRACT PRICE OF WORK <br />WORK DESC�IPTION <br />P�to��pE � ��151'qw P��M�irl4 1`rKT�R.eS +� f�6i.ATa'D F.Clu�p,µ6rJT, <br />N0. � TYPE OF FIXTURE OR ITcM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />l,'rinal <br />Drinkino Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other A�R � �AG ouft.fCTS <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heatpunip <br />Unit heater <br />Boiler <br />Retrigeration <br />Woodstave <br />CITY OF EVERETT LOCAL SAlES TAX CODE IS 3705 <br />I hereby ceritify thal I have read and examined this applicalion and know thc same to be true and correct. AII provisions of laws and <br />ordinaces goveming this type of worfc will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give authority lo violate or cancel the provision of any other state or local law regulating consW ction or the performance ot <br />construction. That I am authorized by the owner of this property to perform ihe work for which application is made and I comply with the <br />Sta e Contractors L�y 1827A A_ RCW and 296.200 WAC. � <br />i <br />ivNap��G� � • � �- � s <br />\� � <br />