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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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS ���/ 7y>N �.� S� <br />7 JJ <br />PARCEL TAX I.D. # <br />Oo39g--7ao/co7-02- <br />PERMIT # <br />N uI C) <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />OWNER '-- DRESS CITYILP PHONE <br />;Nf p//E. NUTA�N ZSrl 7q -rN lr sC CVdfrT U14 QiPZOS ?3o- 17 <br />TENANT NAME CONTACTFORPERMI PHONE <br />/�✓�✓ �t,E.c,1i�M�N U� �IJ-S-yB/-gGtio <br />CONTRACTOR 6y! J66JADDRESS 102yQ CITY/aP PHONE <br />,,1ii0jja <br />�1 <br />�14 AI " 5� �X�/ iy0-gs,'1 �� <br />CONTR. LICENSE # C tIN.DA6S�73T9 L 141R Wo// <br />�II NJ� <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric Gas _Other <br />WORK DESCRIPTION <br />/NPnPLG/n/G�NftA/ (/<lGu/LivG3 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITr.M <br />Toilet <br />PJC — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water healer <br />_ <br />Kitchen sink 8 disposal <br />rD <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Laundry tray <br />_ <br />Range hood <br />_ <br />Sink (service/barlmopletc) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />_ <br />Heat pump <br />_ <br />Urinal <br />_ <br />Unit heater <br />Drinking Fountain <br />_ <br />Boiler <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodstove <br />_ <br />Root drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certlify that I have lead 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 permit does not presume <br />Igive aW y to violate or cancel the provision of any other state or local low regulating construction or the performance of <br />construct n. hat 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 C ra ors Law 18.27 RCW and 296.200 WAG <br />-(° °i <br />gn ure o er/ ontracior Ul orize gent Date <br />