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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982'11 <br />425-257-8810 -FAX 425-257-8857 - %, vw.eve :Wa.org <br />( <br />J OJ'� ,x_l S �_ APPLICATIONS ARE ACCEPTED FROM 8 AM 1 PM <br />SITE ADDRESS -111 IZTN STREET SE PARCEL TAX I.D. # I PERMIT # <br />-r <br />l� rr W/i �f32� 2e,r I�IoD 300 IIJ/J�L/H'(/J((/!!7 <br />LEGAL LOTNO. BLOCK TRACT <br />DESC. Ql��/ SEE 1TpGNEy <br />OWNER ADDRESS C1 rY/zlP <br />r,46AMC, Ce-.TE S / JNG. (0533 SeAJIFt^I NW SbA ftE CIA <br />{783•1g99 <br />F� bStjLUUAKJ _ _��2d q�ll-I <br />TENANT NAME <br />FtLEs" cor ICLncws <br />CONTACT FOR PERMIT PHONE <br />I W&IELLAN PRGutTE&vS <br />64Y2ri) �PiS— 4�Oo <br />bAJID 6AI 4ef=- <br />r_-)t9y_ McGULLOcH _ <br />CONTRACTOR. -r jj E IATER,1A-nej0*L ADDRESS CITY/zIP PHONE <br />MUk-ILTED (Zob) <br />Lor rr« Ten WHEIELCK P.O. ei7X qIZ <br />CONTR. LICENSE# r4A q87_-jc5 7�83-p( 5_ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />r <br />_` I I✓ 'jAL� <br />)�, Electric Gas _ Other <br />WORKDESCRIPTION LphiSTg.UGt10t.1 OF fjEW S1550 "Fr' <br />Lj(EFl COMHERLtA-L P�JILD/r�l� ; INI�Fti�2 NMST Ih4P1�JEme r-S <br />A'SS6LIMLD S(T5 IP4pFoVEMC/JTS� <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />2 <br />Toilet <br />_ <br />AIC - air handling units <br />Bathtub <br />_ <br />Fc :ad air systems <br />2 <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />\ <br />Shower <br />Water healer <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Ihes washer <br />Clothes dryer <br />_ <br />_ <br />La ry tray <br />ngeh od <br />2 <br />Sink rvice/bar/mop/etc.) <br />_ _ <br />Ex usfan <br />Backflo revenler <br />Heat p <br />_ <br />Urinal <br />__ <br />Unit heat <br />Drinking Fount <br />Boiler <br />Floor drain <br />Refrigeration <br />\ <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />__ <br />Other <br />Other <br />\\\ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify 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 slate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with ir.a <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owner/Contractor/Authorized Agent Date <br />