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{ <br /> 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 B AM TO 4 PM <br /> SITE ADDRESS � PARCEL TAX I.D.# PERMIT <br /> I W CPs'� D �vh'D - 3 z o�d651 D lol Q '�0�- �'; > <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYiZIP PMONE <br /> �N11.�Rs�i' �i�k CdJoorn�rJ;�Ms 143o wCAs►� �V �1t�tC °�82a4 <br /> TENANT NAME CONTACT FOR PERMIT PHONE � /p62 Tp2�� <br /> ��Stf 4'DRk I .11N�'(NG�� �'iL6J�1� ���•n!ni�JiM@1�1t;uG�Af4F1QlGtf. <br /> L3ATFfdI: �D � <br /> CONTH. LICENSE M <br /> USE OF BUILDING I NEAT SOURCE I CONTRACT PRICE OF WOHK <br /> (,01��114i�i�1�'� Eleciric Gas Other � `' S��' �— _ <br /> WORK DESCRIPTION <br /> a,�E � ��E s�o»� ►� � ���� �uJ�E ��Rs <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ . loibt, � • � � ' - , �, '�__. NC–air hendling units � ' <br /> 6alhlub __ Fo�ced air systems <br /> Lavatory(wash basin) .__ Gas piping <br /> Shower W alsr hea!er <br /> Ki�chen sink 8 disposnl Gas�ireplace <br /> Dishwasher __ Gas range <br /> Clothes washer Clothes drym <br /> Waler heater _ ._ Range hood <br /> Sink(service/barlmop'cic.l ___. _ Exhausl�an <br /> ___ 6ackllow prevenlr.r .. __ Heat pump <br /> Urinal __ Unit hcaler <br /> _ Drinking Founlain ___ �oiler <br /> Floor drain _ _ Relrigeration <br /> _ _ Grease hap _ Woodstove <br /> Rool drains _ . Olher_ _ <br /> Othcr <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby centily ihal I have read and examined this application and know Ihe same to be Irue and cor�ect. All p�ovisions ol laws and <br /> ordinaces governing Ihis type of woik will be complied with whether specilied herein or noL The granting ol a permit does nol presume <br /> to give authority to violale or cancel Ihe provision of any other state or local law regula�ing conslruction or the pertormance ol <br /> construclion. Thal I am authorired by Ihe owner of Ihis property to perlorm the work for which application is made and I comply wilh the <br /> St Contractors Law 18.27 RCW and 296.200 WAC. �'7 <br /> W U9 23 � <br /> nali e of O ier� ontracta�Authonzed Agen! a�e / � <br />