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APPLICATION —� <br />PERMIT APPLiCA.TIC�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />..SP eRMIT <br />425-257-8810 —FAX 425-257-8857 — www.everettwa.org <br />.w.�,e — <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.. <br />SITE ADDRESS <br />PARCEL TAX I.D. k <br />P MIT N <br />.�bn1L <br />sc <br />S�.o �, S� <br />0.�3u1v <br />G'�5,� Donn a <br />LEGA LOT N0. �Q BLOCK TRACTOR SUBDIVISION N O COM � C72. �• Gk,7'1, I n S /� � je�JO Eip N i <br />IC <br />DESC. ��7I.IDr �i�-— <br />OWNER ADDRESS CITY/ZIP PHONE <br />�- bus � A�n LCL ►n c*n4� S?o 9a �'E s=�u�sh/���8 <br />�'.u�$ n S:neaSL�Id <br />1�11� <br />� n'� <br />TENANT NAME <br />4xu <br />PERMIT PHONE Yz � L 39L 19 J <br />1L <br />�C,!ONTAC�nT�FO.�1R <br />/�/�/�LL� //l EMAIL <br />z`aRTR�rciair-- — I <br />�1:.1.'� I�ao➢ fa,o P�✓e➢1[u uF SLP1�91 <br />Itif1I� ��I�r� Cevlr'F. faro �ol�°N� /�Islrl%q�'z�o QZ�Z39Z�91 <br />CONTR. LICENS M <br />lhl � �- HC �"ly7SS <br />USE OF BUILDING I <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />/vl�Vd yy <br />�l \ <br />�' Electric _Gas _Other <br />WORK DESCRIPTION ,,// � a� �BcfSe <br />'V:A�r caA law«J Rai nf•Y•�' <br />DeP`d�, e0(J�/►^2.v� /DpRc`� r11� '�nvr <br />Ro�L.A. <br />f3u,IG� 7'(n110 L K S <br />[...�. <br />txaor tnp eu; P.. �...J <br />C�,�a�� � �i7e>~�- d-tlo�� £� g 3 0'�-- <br />/ <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C -air handling units <br />_ <br />Bathtub <br />_Forced <br />air systems <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />Water heater <br />Shower <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range rr <br />Clothes washer <br />_Clothes <br />dryer <br />hood <br />_ <br />Water heater <br />Sink (service/bar/mopletc.) <br />_Range <br />Exhaust tan +� <br />_ <br />Be :k0ow preventer <br />B. <br />_Heat <br />pump <br />ter, <br />Unit hooter <br />Urinal <br />Drinking �. <br />Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />:,:Jm:...... <br />Grease trap <br />w... <br />Woodslove <br />Roof drains <br />_Other <br />_ <br />aN <br />Other <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cerllity that I have read and examined this application and know the some 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 I) violate or cancel the provision of any other state or local law regulating construction or the performance of <br />by the this to perform the work for which application Is made and I comply with the <br />construction. That I am authorized owner of property <br />State Contractors Law 18.27 RCW and 298.200 WAC. <br />lure of ner/ ractorlAuthodzed Agent Date <br />