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flpr YY ❑V II:40a firca 2066221r'7 P.6 I, <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREI I, VVA 981201 <br />425-257.8810 — FAX 425-257-8857 — mvvi everellwa or(l <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. N <br />21 3o I l�, T1'f 5ra't�r_r 2�Osz9oo21 <br />LIFGAa LOT NO. BLOCK TRACTOR SUBDIVISIONS <br />e_ -t4nSpACC Zntc. 91 M040P1 S XET <br />PERMITS -)/ I <br />v <br />__._ _- —1 <br />20(n. (07-7-.6059 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />NONE I JOE CgeA2-IA140 zoG. Sbt.k-ti 0 <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />.3. b. iJ EVJ Tb� Gf.K.15I'QVg101� E o <br />CONTR. LICENSE S P O. 13e,X 60%-$� <br />Jd pEW C19 53L C <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />\I Ar A ar I Electric —Gas—. Other <br />WORK DESCRIPTION <br />,L !MOr--1-T`.01J <br />NO. I TYPE OF FIXTURE ON ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basr, I <br />Shower <br />Kitchen sink A disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />_ Backllow preventer <br />_Urinal <br />_ Drinking Fountain <br />Floor drain <br />Grease trap <br />Rool drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />T Exhaust fan <br />_ Heat pump <br />Unit heater <br />Boiler <br />_ Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cenldy first I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordineces 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 state 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 the <br />State Contractors Law 18.27 RCW and 296.200 WAC <br />�iN�1°I�B I rtc- <br />