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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS � � � ��� � 5� <br />PARCEL TAX I.D. # <br />PERMIT # <br />Oo 435 7000po 4 02 <br />Or� <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. lj A'E yI OFS <br />EWIER 5UA1 TEILA~u: <br />OWNER ADDRESS CITVIZIP PHONE <br />E Z R A N <br />.5 (-7 9 2 "w 5* SE � vlarcET-r <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR QkrK WSTo w{ /jCOGS ADDRESS 1827 CITY2IP PHONE <br />Sf:3- <br />CONTR. LICENSE # <br />USE OF BUILDING <br />NEAT SOURCE <br />CONTRACT PRICE OF WORK <br />�T n � 1 ° '` <br />I — Electric Gas Other <br />#0 Z (, U`',,' <br />I <br />WORK DESCRIPTION <br />(-'2 /h'vyL 6'12gG-& (ly'6` Crn k5 <br />p(oK 3`ICi" <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toile <br />A/C .air handling units <br />_ <br />Bathtub <br />_Forced <br />r systems <br />_ <br />Lavatory (w basin) <br />Gas plpin <br />Shower <br />Weterheale <br />Kitchen sink 8 dis at <br />Gas fireplace <br />_ <br />Dishwasher <br />_Gas <br />range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow prevenler <br />_Heal <br />pump <br />_ <br />Urinal <br />_Unit <br />heater <br />Fountain <br />_Boller <br />_Drinking <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Root drains <br />Other <br />_Other <br />CITY OF EVERETT LOCAL SALES TAX CODE 18 7106 <br />I hereby cerilily 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 slate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this p <br />rIL <br />operty to perform the work for which application it <br />