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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 />J <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM c� —� 'O <br />SSADDRESS A^ <br />#yam I PARCEL TAX I.D. p <br />PERK !J66OO <br />SL �w <br />1 <br />OU/ <br />LEGAL LOT NO. <br />BLOCK <br />-TRACT OR SUBDIVISION 0 <br />DESC. <br />WNER ADDRESS CITYIZIP PHONE <br />\'C.0 <br />flow <br />TENANT NAME <br />-TY(o rz Co�heo <br />CONTACT FOR PERMIT PHONE <br />D u� z� -1-100 <br />E-MAIL <br />rONTRACTOW-- ADDRESS PHONE ;Iofo <br />p J` Q _A VL /Ld I - ` ) b <br />CONTR. L E�S QQ <br />�(NI t�fltI0G <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />XElectric —Gas —Other <br />I <br />WORK DESCRIPTION <br />/SOD Z �� <br />llt,A�1r�v/��Wetcl,.�S. .N' /� , � -1y ��� /{/�1 , .` �1y-(- I�,/1� ���'�✓��y/�1,�/q 1 <br />Y �Yl�(J �iC���/^�1 -/r•'V • VIA' \`--" _ \ Il1 �'�"^� <br />l�� � �'Y�la'�-Li <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C - air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water healer <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (servicelbar/mop/etc.) <br />Exhaust fan <br />_ <br />Backllow prevanter <br />Host pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Flour drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />Root drains <br />Other e�%vllLliffi 5 <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby corilif) 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 hnrein or nn'.. fh^ granting of a permit does not presume <br />to give authority to violate or cant the prevision of any other state or local law regulating construction or the performance of <br />construction. T t I am aulhortze y tho owner of this property to perform the work for which application Is made and I comply with the <br />Stale Contract 'Law 18.27 C nd 29 .200 WA—. <br />U <br />of Owner/Cont"clor Aulh ized Agent Date <br />