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� — I� —� ?� <br /> P�RMIT 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 ADDRE�S PARCEL TAX I.D.il PERMIT# <br /> '7ra� �j � /�y� (,,� Qa7080ocoo3��0 ��o�6c�5 -�l °l <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ST�,�E Ttt�nz�S 7 z,�� 6� ,4v�r.J ��rc�n- 9Yzv 3 Nzs-9z�-7�/G z <br /> TENANT NAME GONTACT FOR PERMIT PHONE ?�� .�o$=6!o G <br /> "�� E•MAIL <br /> CONTRACTOR ADDRE CITYIZIP PHONE <br /> (�t�✓�-itz� b!S— LtJL��.✓v �o <br /> CONTR.LICENSE# ��4qit��c�j(o3Ly '� �✓r pS(zr�3 3Go-TcS=Giv(9 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> K EI?ctric Gas O�her �pp �a <br /> WORK DESCR�PTION <br /> —1.Nsn�-t ,Ve�J �iAY LiN�= rv2 f�m� . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel AIC—air handling units <br /> Bathtub Forced air syslems <br /> La��alory(wash basin) �j� Gas piping <br /> Shower _� Waterhealer <br /> Kilchen sink&disposal J_ Gas(ireplace <br /> Dishwasher Gas rarge <br /> Clolhes washer � Clothes dryer <br /> Water healer Range hood <br /> Sink(service/badmoplelc.) _ Exhaust fan <br /> Backflow preven�er _ Heat pump <br /> Urinal Unit healer <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigerelion <br /> I _ Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify thal I have read and ezamined this applicafion and know the same to be true and currect. All provisions of laws and <br /> ordinacas governing Q;is rype of work will be complied with�vhether speci(ied herein or noL The granting o(a permit does not presume <br /> to give authority lo violate or cancel lhe provision o(any other slale or local law regulating constniction or lhe performance of <br /> wnstruction. Thal I am authorized by the owner ot lhis property to peiiorm the work(or which application is made and I comply wilh the <br /> State Contraclor;larv 18.27 RCW d 298.200 WAC. <br /> , - `�C;��---- �/7��r <br /> -Siynalu�e of Owne�C tract Aulhorized Agent Dat <br /> \ __ I✓ <br />