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F A.-RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �G <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org 7 " <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT &CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS S✓ITE ZS-0 PARCEL TAX I.D.N PE MIT <br /> IIII a)-tit r 5'0. r.VEaFT>- I I -LZ804-3 -"4g--oao z I � O 3.7 <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> 56, /�'- Cort' • 150f N, 200 A Z06 - 53.3 -21`11 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> MAIG,NON\ IZe,p6r/L MA r, n/ Zolo -- 90'? 07 <br /> CONTRACTOR ADDRESS CITYIZIP PHONE 2c6 533 -74 <br /> iG Co � P • r5ol tJ. zoo SHor4�tINL? wA, q8/3j <br /> CONTR.LICENSE N <br /> SGA CO " r 68495 <br /> USE OF BUILDING I — HEAT SOURCEI CONTRACT PRICE OF WORK <br /> en <br /> M++ GiLICA L Electric YGas Other Or 55-7 <br /> WOR�KDESCRIPTION <br /> 13U rG SPAe-✓= ocF oc E-%IST/NC, ol'FICE 5P'4C1--:- <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 dryer <br /> _ Laundry tray Range hood <br /> _ Sink(service/bar/mop/etc.) _ Exhaust fan <br /> _ Backfiow preventer _ Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain Boller <br /> _ Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cedtify 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 ontra;tors Law 18.27 RCW and 296.200 WAC. <br /> JJ11�d/11��, G —17 <br /> Sin of Owner/Contractor/Authorizedgent ate <br />