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. � 6; <br /> PERMiT APPLI�CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C:!:DAR STREET, EVERETT, WA 98201 <br /> 425-257-SS i�- FAX 425-257-8857-www.everettwa.org <br /> _ APPLICF,I'f VNS ARE ACCEPTED FROM 8 AM TO 4 PM 1� ,.,�� `� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �nvZs Iq�'+A+feNUE sE� surf�2a1.� qW7�ovoZo�oo I /�/Oo� • ���j, <br /> LEGAL L07 NO. BLOCK TRACT OR SU DIVISION# �� <br /> oEso. �c1ia� ?o a�•��2P�!t�irq� o�. t� �ar-tar Uw �0025 ►Qrn INC 5E <br /> OWNER FDDRESS CITYIZIP PHONE <br /> �R.Ro�E�c J• t�ufau�S, v�5 loo�s 1q�AVE 'sE �200 �V�n" w�+ •4?n.33'2. b 8�5 <br /> TENANT NAME rnNTACT FOR PERMIT PHONE��,�p, OZOO <br /> CR• slkaN�ti Er�1�a�� Chris}jylc �►1�A. <br /> S3' B,q��•i�• (�o. e•maiGhriStiYK'J�JIxIticy-� cw�r, <br /> C NTRACTOR ADDRESS CITY2IP F' 1- ' <br /> LoNSTAN'T1NE BMuaERS�ING• (QA�(D BALU1JbIER-W`� NE �010E FoRCsT 4�1RK , <br /> CONTR.LICENSE# 5 <br /> GON9t81q02�'#` �P• 4126(12 Wlr `�g155 ZOIv.`157•4�m <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �r���-lr1VOl� �p� �Electric _Gas_Other � �� ��O�O. � <br /> WORK DESCRIPTION 2,io7 Lf Tcna,+t ImFRou�er,r Foa. �„ �e�,nu, cuu�� w n t�+ev►ou��Y ouuQ, <br /> SW.7'�,WGAYED ON'I}FF �nd Fl.oOR oF A 2 sfOR-Y DIMi.DINE1• IMPR��NtS MKJ.uo6:GONSiRut�uN oF <br /> N�w nwN-sta�uet►+.wH, �woR PaRnnoNs,i�µova�, aF�sn►�W NeN�tl�uetxsrqe,pawtir►o�ts, <br /> I p�,6l�ApiNq�Nq11'f11ut��u►6�K�(Y�y.MlD l►{(C�as F1N►6H s. MF-U1AIJ�tA+.� �l.Et,Tt+�►cAf.� PI.itIW31 � <br /> Y-VER PND FR�AlARN su�N►9iA�Vs AR� PIC TO �E SuBM�ttED SUBtDNTr+.a[. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 2 Toilet 'L� A/C-air handling units <br /> '^ Bathtub 'y Forced air systems <br /> � Lavatory(wash basin) . Gas piping <br /> � `Shower ��Water heater <br /> � Kltphen sink Y.c{isyeseF �SIY1{L OY1�y� = Gas freplace <br /> � Dishwasher -� Gas range <br /> t Clothes.washer � Clothe�s dryer <br /> � Waterheater � Range�hood <br /> ' Sink(servicelbadmop/etc.) � ExhaustYan <br /> � BackOow preventer = Heal pump <br /> � Urinal Unil heater\ <br /> � Drinkino��ountain �- � Boiler �� <br /> -� Floord:ain � Refrigeration \ <br /> � Grease trap -� Woodstove \ <br /> Roof drains � Olher �� <br /> Other — <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �I <br /> I hereby certify that I have read and exammed this application and know the same to be true and corred. All provisions of laws and <br /> Iordinances governing this type o(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 Co tors 27 RCW anc�296.200 WAC�� <br /> I � �-C�jV' �' �1 •2'�'.�0 <br /> Signa�7 of O n dContracror uthonzed Agen Date � <br /> � • '/� <br />