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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 l>iJ 9/D -o l� <br /> SITE ADDR SS 41, <br /> ` PARCEL TAX I.D.If PFVRMIT i <br /> -J -Q(o - p ri �9io 007 <br /> LEGAq LOT NO. BLOCK TRACT...O p0� L'O" OD <br /> DESC. /3 <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> '37-Al L LLC <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR1J. ,^C_r ADDRESS CITy21P PHONE <br /> L.•c " -�oMcs !N<. ?tM3 A� -` (' 1/ �ll�^ZS9• Ge� <br /> CONTR.LICENSE p ' r~ G Z I SIC Cj 1`l t 1 1'l �- teaG/VS <br /> �ACAIC14 q%8 LF wA satz�� — <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric XGas—Other <br /> WORK DESCRIPTION <br /> �L)(" c` A. r �� 21 rq <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �_ <br /> Toilet A/C—air handling units <br /> Bathtub i Forced air systems <br /> t_ Lavatory(wash basin) 4J� Gas piping <br /> i_ Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> I Clothes washer J Clothes dryer <br /> J�— Water heater I Range hood <br /> 1_ Sink(service/bar/mop/etc.) Exhaust fan <br /> _ BackBow preventer Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> _ Grease trap Woodslove <br /> _ Roof dralns Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cedtify that I have road 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 compligd with whelher specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision oan ther state or local law regulating construction or the performance of <br /> construction.That I am authorized b jltaov this proper y dorm the work for which application is made and I comply with the <br /> State Contractors La 18.27 nd 296 00 AC. <br /> 10 ISrU°► , <br /> Signature of Nu o <br /> �.wner/ onlract aed ent ate <br /> 61 ^ IS <br /> , Va <br />