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1'6-06 <br /> PERMIT APPLICATION <br /> CI 1 ; OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEI, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8851 -w,vw everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM co•-3I "� <br /> SITE ADDRESS E1lle r PA CEL TAX I.D.A PER A <br /> I I D S( 1 $2-03 IZ25' _3 -00-DooZ C "IT <br /> �oS" <br /> LEON LUTNO. BLOCK TRACT <br /> DESC. <br /> OWN R ADDRESS CITY2IP PHONE <br /> 566 C'Z4 If SZ//krLn/ Z601i- 57" 5&466.161 k4 �rj U-3 3a1 146-S 3 3 - Z I <br /> TENANTNAME CONTACT FOR PERMIT PHONE <br /> U1 bQ0,AI66 T• I HIVID huor-) ;7-047 Z 7 ZzZ <br /> C NTRAC1vR ADDRESS CITYMP PHONE <br /> C'DNSTiWeTt&j 78SY Sc) Ztlat 57 jkti ILIA Z S 3 Y7Z-7ZZZ. <br /> CONTR.LICENSE 9 1j'n•�- l�#� Z 1]un'Z qjt 52 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric — r U <br /> t�/AR�/DUSGElectric _Gas Other <br /> WORK DESCRIPTION A� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF 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 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clothes diger <br /> _ Laundry tray Range hood <br /> _ Sink(servicelbarlmopletc) Exhaust fen <br /> _ Backfiow preventer Heat pump <br /> _ Urinal 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 7105 <br /> 1 hereby ceritity that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinates 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 /> construction. That 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 Co tract on haw 18.27 RCW and 298.200 WAC <br /> Signature o er olractoDate <br />