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PERMIT APPLIGATION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 320G ��EDAR STREET, EVERETT, VVA 9£3201 <br /> 425-257-8810 — FAX 425-257-8857 —www.everettwa.org "' ,3 ���� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AP�� TO 4 PM - DEBIT &CREDi7 CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS��r� PARCEL TAX I.D.# PERMI # � <br /> .�'�i -$�'-/3�ST. 29a5/80020¢500 i l��j - ?l� <br /> LEGAL LOT NO. BLOCK TRACT <br /> i DESC. <br /> OWNER ADDRE55 CITYIZIP PHONE <br /> /�o�?T OF El�EiPE TT 29///jOrVO ST. El/EiPETT 9BZ06 4ZS-3BB-06 03 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> PoL/ L U/S 4Z5-388 - 0603 <br /> � CONTRACTOR ADDRESS CITYIZIP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleclric Gas Other �� iL/ <br /> � WORK DESCRIPTION ���. " <br /> ::�EMo�isHEXiST/NG �U/�O/��G No. 9 C <br /> �M �Z) ��`' <br /> PLUMBING MECHANICAL <br /> t10. TYPE OF FIX?URE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toil�l A/C—air handling units <br /> Balhtub Forced air syslems <br /> __ Lavatory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clolh�.s dryer <br /> _ Laundry Iray Range hood <br /> _ Sink(senice/bar/mop/elc.) Exhaust fan <br /> BackOow prevenler Heal pump <br /> Urinal Unil heater <br /> Drinking Fauntain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodslove <br /> Roof drains Other _ <br /> Other <br /> i _ — _ i <br /> CITY OF EVER[TT LOCAL SALES 7AX CODE IS 3105 � <br /> � I hereby certl.`y that I have read and examined lhis application and know lhe same to be true and correcl All provisions of laws and <br /> ordinaces governing this rype of work will be complied with whelher specified herein or nol.The granting of a permit does no� presume <br /> to give aulhority to vioi��or cancel lhe provision of any other slate or local Iaw regulaling conslruclion or the perTormance of <br /> constructioa That I a�i a b rized by lhe owner of this property to perform lhe work for which applicalion is made and I comply with lhe <br /> Stalc ^.onlractors La� 1 .P7�,tC and 29G.200 WAC. <br /> �� � � �;,�)�'.C.'� <br /> 2 ,naWre of Ownedl,>7�j�o d lhorized Agenl Date <br /> t1 <br />