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PERMIT APPLK" ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everett.wa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS Iy't - gat+ Sr SL-1 <br />PARCEL TAX I.D. III <br />PfrRMIT 0 <br />SutT� ci I <br />✓ 0 Z'L <br />/S to CIL <br />LEGAq LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS CITYIMP PHONE CZC.,t.\ <br />`525//z-� <br />S26 r� �c� crr�T�-rt ��-c U9�2 r1� 9"7i+, S�Ai'(UE `t81Iy <br />TENANT NAMES JL-A'n <br />CONTACT FOR PERMIT PHONE <br />Cogk ,sTia4Tv-t (Zc C(QIL5 -ZSS-'S <br />CONTRACTOR r4�p�`L /.ODRESS CITYIZIP PHONE <br />CcN-�sTF-ice ter-' IZS-7 W6sr+.Pf� M1E N • C2o�� `11S• �';� <br />CONTiL LICENSE #�i•.1(J / <br />/ _ <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORM. <br />o �C_.r'- /W ArS F � I SCE <br />Electric Gas Other <br />I <br />_ _ <br />WORK DESCRIPTION <br />Nb � 0 —%1 SH�cS <br />slim �+ <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C - air handling units <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />Sink (servlcelbartmopletc) <br />_ <br />Exhaust fan <br />_ <br />Backilow preventer <br />_ <br />Heal pump <br />Unnal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refngeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby centify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordlnaces 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 Ic:al 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 C tractors/' aw 18 27 RCW and 298 20D WAC. <br />Sig n ture o wnen ontractorl ut orizeaAgent Vate / <br />L <br />