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I - <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.ever(�".wa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS I LI1"c' SD1-% m S"-1 PARCEL TAX I.D.# PERMIT p <br /> 5.111,6 G GLIe'fi 'T-i- Ooh ZZa000Zoo?j fj ` -(`,�{ <br /> LEW LOT NO. BLOCK TRACT <br /> DESC. C <br /> OWNER ADDRESSCITY/ZIP PHONE <br /> rrL� v mcf�� c T:�ry Lac S2 r�F9�f+� S�rn> cr811r <br /> xuS zoo <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> L,Arl dC4 P- I *C>1-17 W e C-0, , 01rd-! <br /> 5�l)f fmdpTp �Ar-y- I FGJf'mH 4bA Z772-JI Tl r---j (<p >) L1 <br /> CONTRACTOR P � ADDRES3 CITYRIP PHONE <br /> STr-,j 1237 w&- arm, ^-4 r-J <br /> CONTR.LICENSED �i , NOGCPS I,,;,clk-07;, 08�� (,� Lll$_ <br /> USE OF BUILDING c Iry ) HEAT SOURCE 1 I CONTRACT PR CE OF WORK <br /> urli(� 1 ��1 I _Electric 1�as_Other <br /> �., `'' <br /> WORK DESCRIPTION �'`ac(STf rS�, -r��-a-y� sf� <br /> w1 �F <br /> t-otz <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Z Toilet PJC-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 /> _ C'shwasher Gas range <br /> _ C..,Ihes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> _ Sink(servicelbarlmopletc.) Exhaust fan <br /> _ Backflow preventer Heal pump <br /> _ Unnal Unit heater <br /> _ Drinking Fountain _ Boiler <br /> _ Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains Other <br /> Otherl.w <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceritify that I have read and examined this application and know the same to be We and correct. All provisions of laws and <br /> ordinaces 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 wrath the <br /> Slate C actors Law 18.27 RCW and 298,200 WAC. <br /> Sigrfature of Llwner/L;ontraCtor/AUthorizea Agent Uate <br />