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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />'200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE <br />ACCEPTED FkOM L AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SI7 E ADDRESS <br />PARCEL TAX 1.0. p PERMIT p <br />B3-z 8--tv, ST Sx.1 <br />Z 4, IZeQ e5 b- -' ', 1 <br />legexeei <br />�-- <br />LEGAL LOT NO. <br />BLOCK TRACT <br />DESC <br />OWNER ADDRESS CITY/ZIP ` PHONE <br />5�313v' JET r <br />•Tl�j,-95eo <br />L—L. C. <br />�j10 tGc.l1, A>J'c NE Ioo '' 9 y <br />TENANT NAME <br />f <br />CONTACT FOR PERMIT PHONE <br />)1,10 JAT'Ec-H <br />SET3E isjd4rsc-r �Ay izS-zsSi <br />CONTRACTOR <br />ADDRESS CITY1171P PHONE <br />--�-7.� <br />II r� <br />CONTR. LICENSE 0 <br />USE OF BUILDING <br />HEAT SOURCE <br />PRICE OF WORK <br />[,r-rj�� /W� <br />I _Electric Gas Other <br />.lCONTRACT <br />I eLb�a�r g(Do•"� <br />. <br />WORK DESCRIPTION <br />Cam- <br />c E s�.qc� F7r tt-�.rd <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — au handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />__ <br />- _ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />__ <br />Range hood <br />_ <br />Sink (service/barlmopletc) <br />Exhaust fan <br />_ <br />Backllow preventer <br />,_ <br />Heat pump <br />_ <br />Unnal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refngeretion <br />_ <br />Grease trap <br />Woodstive <br />Roof drains <br />Other <br />Other <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read <br />and examined this application and know the same to be true and correct All provisions of laws and <br />ordinate governing this type of <br />work vnll be plied wdh whether specified herein or not The granting of a permit does not presume <br />to g've a hority to v,olate or can <br />the pr Ision of any other state or local law regulating construction or the performance of <br />constructi n That 1 am aut onz <br />by th owner of this property to perform the work for Witch application is made and I comply with the <br />State n R <br />and .HBO WAG. <br />`\ <br />J • J; . <br />`i <br />I u oniractor <br />uthonzed gent ale <br />