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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 I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.K PERMITS <br /> IIII Qc�}h S{. SW. 122004 -3- 044- 0002 <br /> LEGAL LOTNO. BLOCK TRACT 1 <br /> DESC. <br /> OWNER ADDRESS Cny171P PHONE <br /> SC-IAUI-THGl5 A%cZAATM5 641q 2041h 5f. S. J. e;,4eZ00�Lyr.lwaea,?6034! 778-21111 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> &c l GLOBAL ffb I 'BC'0-)T 11C&P4W (25?) ecq- 0" <br /> CONTRACTOR �DQp eC,,Va4,,w INL,ADDRESS CITY2IP PHONE Cps <br /> nCDRRPI 1151CM GII W. VJL-GY OwT,. S RMr--ic ; �Nd�7 `_ 040 <br /> CONTR.LICENSE e <br /> USE OF Br11LDING A5s`H&1'4-:'4;t5 HEAT SOURCE CONTRACT PRICE OF WORK <br /> pc fL, W l "Tic 1 oecul7 RoRCl15, I _Electric -X Gas_Other I.�, 32 y <br /> WORK DESCRIPTION /)'r14LM6T j 0p 24 b+,5.5 c)r= AALLAI-r ahCkIA1y, <br /> 3 LejcV Ls / Bray 51 1 for, 41b 151 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet _ AIC—air handling units <br /> _ Bathtub _ Forced air systems <br /> _ Lavatory(wash basin, _ Gas piping <br /> _ Shower _ Water heater <br /> _ Kitchen sink S disposal _ Gas fireplace <br /> _ Dishwasher _ Gasrange <br /> _ Clothes washer _ Clothes dryer <br /> _ Laundry tray _ Range hood <br /> _ Sink lservlwrbarlmopletc.l _ Exhaust tan <br /> _ Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> _ Floor drain _ Refngeration <br /> Grease trap _ Woodstove <br /> Roof drains _I Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceribly that I have read and examined this application and know the some to be true and Corect. 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 construrtion 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 510 <br /> Gtate Contractors Law 18 27 RR( and 288.200 WAC. <br /> Sgna ager ontract rl onze 99111 to <br /> J <br />