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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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS e,/O 60A^ <br />LOTNO. I BLOCK <br />DESC. <br />OWNER <br />5 U vVvko1 <br />TENANT NAME <br />27:)/E /Pe/ <br />v/eo14a4^e- Nye - <br />4 <br />TRACT <br />PARCEL TAX I.D. K <br />alX// ZUO 3 <br />PERMIT 0 <br />/CY¢fl Av./ilv�-: e-106 FIL-//-vu.z.. t.✓K <br />CONTACT FOR PERMIT <br />f-�l'�/oLvt d v— <br />CONTRACTOR C9l1 / vet-FR ( 1,4.ORES3 .F-1: �) 5Vx r <br />CONTR. LICENSE$ <br />USE OF ��BUILDING <br />c�_ /!L .rc-L�Ito u5 <br />HEAT SOURCE <br />_ Electnc ZGas _Other <br />rnunc <br />y (Zs3 cl/3 f�i <br />CITYQIP PHONE <br />9&C)7( <br />CONTRACT PRICE OF WORK <br />WORK 0 SCRIPTION Nc��iG �IGC�Iln {(ra[ f �a 1 s�4r/� t�2� C�C+r/Z ✓ 1�� <br />un/7�5� 0) IWAW'f-(q) <br />�n cam � / �Z Grra/'� /w..rftirS w//t1 MS �/�cr+/ ��, Tc .•/�C 9NY/�S' ¢ <br />Cc r tSr `� RSGrHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc) <br />Backftow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />-37 <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />_ <br />Gas fireplace <br />_ <br />Gas range <br />_ <br />Clothes dryer <br />_ <br />Range hood <br />Exhaust fan <br />Heat pump <br />r <br />Unit heater <br />Boiler <br />_ <br />—_ <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify 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 stale 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 Contractors Lew 18.27 RCW and 296.200 WAC. I <br />