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fr <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257-8810 - FAX 425-257-8857 - wArw.eve•ettvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. N <br />PERMITS <br />J <br />I <br />I V lz9 -13 <br />LOT NO. BLOCK TRACT OR SUBDIVISION N <br />DE <br />_.aLEGA <br />R ADDRESS I IP PHONE 42� }6r3 •j r%� <br />- Qr jj -lo C, "r' ( "I ,SL, �Jefe$ l� �l� till <br />TENANT NAME <br />I CONTACT FOR PERMIT PHONE 4LS8— <br />' E-AVAIL <br />Auumituakci.�5cnC1 <br />1J� QCoIS�accsl� y2S 4�141y <br />QA �Cu �A <br />CONTR. LICENSE N _)CkShI n� rat 31 GjA-7, 1J <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />I -- Electric Gas Other <br />I <br />WORK DESCRIPTION <br />�„ Stu I I at- o GC 5 `u)r ,1 c�)T �'vrnGL <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C — airhandlingunits <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas firep ace <br />_ <br />Dishwasher <br />�_ <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc ) <br />Exhaust fan <br />_ <br />BeckBow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floordrain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Rooldrains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinances 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 Contractors L w 18.27 RCW and 296 200 WAC <br />FS"nature of 77onTradIT ifthonzed Agent Date <br />