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PtRMIT APPLICATIGnI <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 �EDAR STREET, EVERETT, WA 9820' <br />425-257-8b IO — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />J-.32'�'r---�02"d F <br />LEGAI� LOTNO. <br />DESC.I� �I lu � <br />BLOCK I TRACT <br />PARCEL TAX I.D. p <br />N <br />.8e��nund Ft�.wus O��Y4}1�, �r 3�2� - 4la-�� P►.��v�vtJ-k 425. ��o • I(e3o <br />TE ANT NAME I CONTACT FON PERMIT PHONE <br />� ADORE53 <br />Cousfu.l Cm�s�fvw�liUn <br />CONTR. LICENSE N <br />USE OF BUILDING <br />•�1�[�]c73 <br />µzs. �'i0. � c,s0 <br />CITY2IP PHONE <br />HEAT SOURCE I CONiRACT PRICE OF WORK <br />_ Eleciric � Ges ___ Olh^r � � � � �,,,, _ <br />Cons�l�►,.�.�.�- ru.w s�nyfti �iin�i l y v.esic/eh.u... �'jl`� 5/� IVN M IiE2 I�i l <br />: �)� <br />PLUMBING <br />NO. I TYPE OF FIX7URE OR ITEM <br />� Toilot <br />_� Balhlub <br />� Lavatory (wash basin) <br />�Shower <br />Kitchen sink 8 disposal <br />__i_ Dishwasher <br />�_ Clolhes washcr <br />_ _�__ Laundry lray <br />_ Sink (service/bar/mopletc.) <br />__. Hackllov� prevenler <br />Urinal <br />Drinkiny Fountain <br />Floor draln <br />Groaso irap <br />� Roof drains <br />o�n�� <br />NO. I TVPE OF FIXTURE OR ITEM <br />A/C - air handlinn unlis <br />�Forcad air sy�t�� ,is <br />Gas pipin� <br />,� Waterhoator <br />_1_ Gas lireplaco <br />J_ Gas ran�7e <br />�_ Clothes dryor <br />(. Rangehood <br />� Exhausl fan <br />Heal pump <br />Unl� he�ler <br />Ooller <br />� Relri9eratior. <br />� Woodslove <br />oine� <br />CITV OF EV[RETT LOCAL 5ALES TAX CODE 19 �105 <br />i hereLy cwili(y Ihat I havo ro�d and examin�ci this app�icalion and know ihe samo to be Irue anA rnrrect. All provisions of laws and <br />ordinaces governing ihis lype ol work wiU be complied wilh whc�lher specified hc:reln or noL The gran�ing ol a permit does not presume <br />tu give authority lo violalo or canr,el Ihe provision ol any other state or local I��w regulating consWclion or lhe peAormance of <br />conslruclion. Thal I am authorizoA ��y Ihe ownei of this property lo �r,rtorm lha work for which application is made and I comply with ihe <br />Stalo Contracturs Law 18.2' RCW and 2�Jfi200 WAC. <br />Signature o wnoi/ onlractorl�u�horized Agenl �— <br />� <br />