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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9b201 <br /> 425-257-8810—FAX 425-257-8857 —www.everettvaOrg <br /> %„ O APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE8S PARCEL TAX I.D.M ERMIT M <br /> C� rh r ASS av�73- 01-D I -OI � 1of�5 _dl� <br /> LECA LOT N0. BLOCK TRACT OR SU IVIS R <br /> DES(- ) + 2 001 L101 SNOHOM I +4 N - jar PLAT 1�OFZ 6A�DN��P <br /> HER ADDRES <br /> DEAN -4 VAIZLA KLGES 17'10(D 914T AVE SE SNIOHDMISN WA <br /> TENANT NAME CONTACT FOR PERMIT PHONE 3(o0-454— 61 j <br /> ISESSiCA ANDERSON E-MAIL U:ccHOMC--q&&rnd1CONTRACTOR .tum <br /> FWiLl-, CWnlr0 CU fducn0MGIFY141" PHONE <br /> po RX !& 3(�C qSq-SI'S7 <br /> CONTR.LICENSE/ i5AC1,ECC942)NZ MkYU5i WR <br /> USE OF BUILDING <br /> HEAT SOURCE I CONTRACT PRICE Or WORK <br /> tM 1'y p( X2L Electric _Gas_�O/ther <br /> WORK DESCRIPTION NEW I3L'Sti1NT��1 ;-� �I.CPLEX <br /> PLUMBING MECHANICAL <br /> N0, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air hendting units <br /> Bathtub Forced air systems <br /> (2 Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> _ Sink(servlcelbarlmoplelc) Exhaust fan <br /> _ BaGcAow 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 1105 <br /> I hereby certify thit I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances 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 /> censlructi That I am authorIded by the owner of this property to perform the work for which application is made and I comply with the <br /> e tractors Law 18 CW and 296 200 W ori/n`/Dq <br /> l�j <br /> ature o wnerl o rl uthonz gent ate K2— <br />