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Sep. 5. 2013 11 :02AM No. 9619 P. 3 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425.257.8810- FAX 425.257-8857-www.everattwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ~`3 <br /> SITE ADDRESS PAHCEL TAX I.D.a PERMIT M <br /> LEGAI Lot nU. Rt.00K TRACT OR SURUIVISION a <br /> DESC. <br /> OWNER D B - - CITY/ZIP PHONE <br /> 6V flIerson,5hamn S. 1a.5 � e._. 42-5 35-602.W <br /> TENANT NAME I CONTACT FOR PERMIT PHONE 4Z5 2tf- +ifs <br /> 1e F.MAIIdebbieCcinhc �11Y1I Oil <br /> CONTRAGIOFCM Q �q�rt� 11�+1� tar 1,ca �vEI' ort �tDDRESS R f-)I ZIP <br /> �2`�ZS�f��t�f� 7 <br /> CONTR�`�C�9.e�f}, 045RT <br /> USE OF BUILDING�7M1 MEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric —Gas—Other <br /> WORK DESCRIPTION <br /> P UMBINQ MECHANICAL <br /> NO. TYPE or FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet _ A/C—air handling units <br /> _ Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink d dlsposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> _ Clothes washer _ Clothes dryer <br /> _ Water healer Range hood <br /> _ Sink(serwcolbadmop/eto.) Exhsusl fan <br /> _ Backflow,prevontor _j_ Heat pump <br /> Udnal Unit healer <br /> �T Drinking Fountain Boller <br /> Floordraln _ Refrigeration <br /> _ Grease Trap Woodslove <br /> _ Roof drains Other_. _ <br /> Other _ <br /> �. CITY OF EVERFTT LOCAL SALES TAX CODE 18 3105 <br /> 1 hereby cerdily that I have read and examined this application and know the same to be True and correct. All provisions of laws and <br /> ordinaees governing this typo of work will be complied with wholher specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the prevision of any other state or local law regulating construction o,the lx+rformanca of <br /> Construrhon.Thnt I am authorVed by the owner of This property to perform Ilia work lot which application is made and I comply with The <br /> Slate Contractors Law 18.27 ROW and 296.200 WAC. <br /> 94.i , . <br /> Ignatu of OwnOtlCopt aClor/Auth i genes— )ala <br />