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07/28/2014 NON 12: 28 FAX 4253551610 dutton canon 0001/001 <br /> r <br /> -- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 25-257-8810-FAX 425-257.8857-www.everellwa.org <br /> I I I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.MI PERMIT N <br /> ,/�g0 rK5-. S 0) SJ 171- Zoo <br /> LEGAL LOT NO. BLOCK I TRACTOR SUBDIVISION a <br /> DESC. <br /> -OWNER 1- ADDRESS 1 ILi r•NONL <br /> TENANT NAME CONTACT FORK PERMIT HONE r,4L.1 • 5'?T r} � <br /> ?avcC ✓/er)Afr E•MAIL6vvde 42 J-wfboierl-oe'/ ?`44 <br /> L6NTRAi 70�— ADDRESS -cff�RlP — TdN� <br /> 'rv7'Yc,n) 'c,f �rrt� C late.? A-.v(e#j. V,0 S��mA.,vlf uLs— 3�7- �aoa <br /> CONTR.LICENSE a au7Tae,r 37P3 $NIy1 A ?G I—VIVAr (N000 WA __ <br /> USE OF BUILDING HEAT SOURCE- COf�TRACT PRICE <br /> j)1 yTvur"F?�YIjA°j�` �] _Electric �Gas_Other r$ CTDJ <br /> WORK DESCRIPTION <br /> 2-0 [on..� DRc+104 � 7�Gn.�� PANEL A 7S KvH <br /> I. fit Ictq I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Tollel _ AIC-all handling unite <br /> _ Bathtub _ Forced air systems <br /> _ Lavatory(wash basin) — <br /> Gas piping <br /> _ Shower Water healer <br /> _ Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher — Gas range <br /> Clothes washer —_ Clolhns dryer <br /> Water hoalor _ Range hood <br /> _ Sink(sorvirnRnarlmoplalc) Uxhaust fan <br /> Dncknow prevenler I]eat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain Boiler <br /> _ Floor dram Refrigeration <br /> _ Grease trap — Woodslove <br /> _ Roof drains Other <br /> Other _ <br /> CITY OF EVERETT LOCAL SALES TAX CnDE IS 3106 <br /> I hereby corldy that 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 typo of work will bo complied with whether specified herein or not.the granting of a permit does not presume <br /> to give aulhodly to violate or cancel the provision of any Other slato or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of this properly to perform the work for which app8rabon is made and I comply with the <br /> Stale Contractors LaW'TB. RCW and 296.200 WAC. <br /> yg /y <br /> Signalute at vv NCO4n Tactor/ uthonre goof Date <br /> i. �� <br />