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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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />-708 gq TN 5T90 E Vcrc t+, WA <br />PARCEL TAX I.D. N <br />I001431 <br />PER�1AIj j <br />, <br />LEGAL LOTNO. <br />BLOCK <br />TRACT <br />DESC <br />OWNER ADDRESS CITY/ZIP PHONE <br />Lawrence. bwola '7d8 Sqv Sr 5w Everef- l q$Zoq yZ5-y38.8133 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />LOwrumc Dayola yZ5-y38.8(33 <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />CONTN. LICENSE k <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />X Electric Gas Other <br />I <br />I <br />WORK DESCRIPTION <br />ZntiullaiC^ or frec r�(4ndinj Feller J & Clr,d den+. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />A/C — air handling units <br />Bathtub <br />_ <br />Forced ar systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc ) <br />Exhaust tan <br />_ <br />Bacpreventer <br />_ <br />_ <br />Heat pump <br />Urinal <br />Umt heater <br />Drinking Fountain <br />_ <br />Boiler <br />Floor drain <br />_ <br />Refrigeration <br />Grease trap <br />Roof drains <br />Wcodstove /. <br />Other ti <br />— <br />Other <br />-- <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 />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 with the <br />State Contrdors Law 18 27 RCW and 296 200 WAC. <br />IOaJ4 12 -!o • oy <br />Signaltire of Owner/Contractor/Authonzedgent —bate <br />