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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 PARCEL TAX I.D. # <br />i4zo 215tst Ev�re� q8�1 00 - 43�0- c3i—�o <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # <br />DESC. 31 nn� 32 433-jJ-0o EVt✓ef/�" 1Jiv B Y'/a7`' <br /># <br />�hony D. lfa�':/i��g 2/oZ t�vyz f1V2 tUCre�982o/ ¢ZS-3o3-/38S <br />TENANT NAiWE CONTACT FOR PERMIT PHONE 2O (7 �� "{gf-�y- <br />,/1/✓/12. L AfiY� F.. //��/$0J9��%/,{OIt /I �Cil�/Cc� E-MAIL �� 7 3��c <br />CONTRA T ADURES ITYIZ P NE <br />l P� t� �p� �,,�/�G/YJ G�l�222J �o _ . <br />CONTR. LICENSE # a�G�C� t/ci �G�ti��- ��J/�a <br />USE OF BUILDING <br />JS'2Sidd/��lit � <br />WORK DESCRIPTION _ <br />�, C�ne. ,r�C�� l��r�i,�� ��i,� <br />�xrs���� �'��� �� <br />NO. I TYPE Cf FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />Lavatory (wash basin) <br />Showcr <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waten c�ater <br />Sink (scrvicelbadmop/elc.) <br />Back(low prevenler <br />l;rinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Root drains <br />Olher <br />HEATSOURCE <br />✓ Electric _ Gas _ Olher <br />G�G�LIr��� ��'4 <br />�>��r�/1.,� . <br />NO. <br />CONTRACT PRICE OF WORK <br />� so, o0 0 <br />//IC�W !� E'G� �D � /1 <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firepiace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lhal I have read and e�amined ihis application and know the same to be true and correct. All provisions o( laws and <br />ordinaces governing this lype o( work will be coinplied with whelher speci(ied herein or not. The granling o( a permit does nol presume <br />lo give aulhority to violate or cancel lhe provision of any other stale or local law regulaling construction or ihe performance o( <br />construction. That I am authorized by lhe owner ot lhis property to per(orm the work for which application is made and I comply with the <br />S;ale Conlractors Law 1E�.27 RCW and 296.200 WAC. <br />��Z <br />