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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425.257-8857—www.everettwa.org l — <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.p I PFftMITA- / <br /> 6I I " S-' SE 064'+1400000101 L- - <br /> LEGAL LOT NO. SLO K T T �' <br /> DESC. iTA r. / - L-f C-• <br /> OWNER ADDRESS CI IP PHONE <br /> (ZEG t— ftMES L.Lr— 230 119 N+ 5r SWJ UE40T WA '19244 <br /> TENANTNAME CONTACT FOR PERMIT PHONE <br /> MAA" L.11 *5 4'"�5-299-5038 <br /> CONTRACTOR Q+1151iAI, MTtMES L.LC_ ADDRESS C �L,..,�! CITYIZIP PHONE <br /> CONTR.LICENSE Z rOr'JN y � `�'1 n'C <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> DuPLE Electric Gas Other L <br /> WORK DESCRIPTION <br /> VI" (,DWiW cti 01IA 6F <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) !6 Gas piping <br /> Shower 'L Water heater <br /> Kitchen sink S.disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> _ Sink(servicelbarlmop/etc) Exhaust fan <br /> Backflow preventer Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> 1 hereby oeritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a perm;t does not presume <br /> to give autRuEn <br /> the vision of any other state or local law regulating construction or the performance of <br /> co ru 'oy a wrier of this property to perforin the work for which application is made and I comply with the <br /> Sit <br /> C tan .20Q WPC. <br /> Sig ure ner! ontractorl ulhonzed gent Date <br /> Z <br />