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PERMIT �+►PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��i� b�D �� U O� <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT# � <br />i � <br />�'�'i'� /? r� G7u�� ..�, rr�� � ��->,{� - �� <br />- �', , , , ,r' oyG dUOOo Y00 _ <br />LEGAL LOT N0. �BLOCK TRACT OR SUBDIVISION # <br />�ESC. <br />OWNER ADDRESS CITY/ZIP PHONE y,� <br />�l,�i'i��s Cr���1� ' /�/� �1�c d �S/s" S„o%M.�� 9��v 5' �o — <br />TENANT NAME � CONTACT FOR PERMIT PHONE <br />CONTRACTOR �� �p�,r`yy,�fj}y� <br />CONTR. UCENSE il � <br />USE OF BUILDING <br />auunt s <br />Ldd /�'� f1rC <br />HEATSOURCE <br />_ Electric �Gas _ Olher <br />�i niur <br />�ryr� %� <br />�� 7D <br />WORK DESCRIPTION <br />�S�U �--�3 , � <br />SE,�/-10_� - o� v <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Qathlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 3 disposal <br />Disliwasher <br />Clolhes washcr <br />W2ler heaier <br />Sink (service/badmop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinkin9 Founlain <br />Floor drain <br />Grease lrap, ' <br />Roof dra;ns <br />Other <br />NO. <br />'' l �2.1� <br />�� <br />CONTRACT PRIC£ OF WORK <br />//� oo� <br />MECHANICAL <br />TYPE OF FI%TURE OR ITEM <br />AiC — air handling unils <br />Forced air syslems <br />Gas piping <br />N'atur heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhausl (an <br />Heal pump <br />Unil heater <br />Boiler <br />Refrigeralion <br />Woodsiove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify thal I have read and examined this applicatio� and know the same lo be lrue and correct. All previsions of laws and <br />ordinar.es goveming this type of work will be complied �+ith �vhether specified herein or not. The yranting of a permit does not presume <br />lo give auihoriry to violale or �ancel the provision o( any olher state or local law reyulating construction or Qie per(ormanc� of <br />conslruction. That I am auUiorized by Ihe owner of this property to perform the �vork (or which application is made and I comply with the <br />Slate CoNraclois Law 1827 RCW and 296.200 WAC. <br />��� <br />