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I- _-- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 i,- FAX 425-257-8857-wwv✓.everetiwa.org g� a�_�( <br /> I �//D — �3 �- A?FL�CA7IUNS AaE ACCEPTED FROM 8 AM TO 4 PM J/�c�n7� <br /> � <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT# <br /> voq s- -000 -c�otC�� oz 8ca-��c� <br /> LEGA L0T N0. BLOCK TRACT OR SUBDIVISION# <br /> DESC. — <br /> OWNER ADDRE55 I:ITYIZIP PHONE <br /> P7���bEtJ4'_ cV�R-�11- M�O �-"�- l3'LI GoL6'y f1vE . �v��'Tr �SZc(� �425 261- <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> 253-333 -�ZhB <br /> Ti��R-0u DAVIS e�Maa �-b.araM1C�,�resvsl-z�-wzst' <br /> CONTRACTOR � ADDRESS CITY/ZIP PHONE ' �T <br /> Fip..r 5�/SYEM$ 1ciE5T Zo(o FRaNYp�E fZP� P�U�c��P 253-5?3 -IL4-8 <br /> CONT9.LICENSEp $NITF G 9gnh� <br /> ��P-cStJ� �L4p�'. <br /> USE OF BUILDING hiEAT SOURCE CONTRACT PRICE OF WORK <br /> MGP+��- ___Eiec�ric _C:as._O�hcr ��-��0,000 <br /> WORK DESCRIPTION <br /> ►NSTpu. IJ:c� �IR-C PUMP'� STGN�PIPCS� 4' SPiNKI.ti(L SySTE"^ 1^� <br /> ��.:.) �,L_�c.� - I2 FLtso 2.S , <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTUFiE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> Toilel NC-air handl�ng unils <br /> Bathtub Forced air syslems <br /> Lava�ory (wash basin) _ Gas piping <br /> Showcr � � Water heater <br /> __ Kitchen sink E disposal _ Gas lireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(scrvicc�badmoplelc.) _ Exhaust lan <br /> Backflow prevenler I-leat pump <br /> Urinal Unit heater <br /> Drinking Founiain _ Boiler <br /> Floor drain Refriqeralion <br /> _ Grcase L•ap _ Woodslove <br /> Roof drains �7� Other�� ,r_�Q/t-�..�11C.�E{L <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3t05 <br /> I hereby cEritify thal I have rcad and examined Ihis application and know Ihe same to be true and correct. All provisions of laws and <br /> ordinaces goveming this lype ol work witl be complied wilh whelher specified here�n or not.The granling of a permit does noI presume <br /> to give aulhonry to violate o ancel Ihe provision of any olher sla�e or local law regulating cons�ruclion or the periormance ol <br /> construction. Thal I am au rized by Ihe owner ol this propehy to perlorm the work tor which applicalion is made and I compiy with Ihe <br /> Stale Contractors Law � . RCW and 296.200 WAC. <br /> � 3 � 09 <br /> Signature ol wner� ractor/Authonzed Agent Date <br />