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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT <br /> 14 W ��s�alc p��� - 3I ocrb65�1 D lol Q 70�- �� a- <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITYiZIP PHONE <br /> �.ser �,�k CENoorn�r���Ms t43� w�sn�b � �ft�tC °u2�} <br /> TENANT NAME 1CONTACT FOR PER1M'IT� PHONE � fpdZ �I I <br /> '���� I J{N�NG' b'Y� Fl1LDt1fJ" 1�� _ "E•MAIL�JIMC9��J/NAQ4{�IK1S. <br /> caara" '�$b <br /> CONTR.LICENSF p <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> (,0�����i�m Electnc Gas Othcr � � ��0 �— <br /> f —� <br /> WORK DESCRIPTION <br /> ��E � ��w� s�o»sc� t� � n���ac,. �uJ�.oP� a.�aM2S <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FI%TURE OR ITEM NO. riPE OF FIXTURE OR ITEM <br /> Toilet . � � � • • ___ A�C—�h handling uni�s ' � <br /> Bathtub _._ Faced air syslems <br /> __ La��a�ory(wash bas�n� Gas piping <br /> S`ower Water heatei <br /> __ Kitchen sink 8 disposal Gas lueplace <br /> Dishwasher Gasrange <br /> � Clothes washer Clothes dryer <br /> Water healer Range I�ood <br /> , , Sink (servica/barhnop'cic I Exhaust lan <br /> _ _ Backllow preventer . Heat pump <br /> Urinal __.. Unil hea�er <br /> ____ Drinking Fountain _ Boiler <br /> Floo�drain __ Relrigeralion <br /> �___ Grease trap _ Woodstave <br /> Rool drains . Olher_____ __ <br /> --- Olher . . . .-- -- ---- <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hr.reby ceritily Ihat I have read and examined this applicalion and know the same to be true and wrrect. All provisions ot laws and <br /> ordlnaces governing this type ol work will be complied wilh whether specilied herein oi not. The granling ol a permil does not piesume <br /> to givr, aulhority lo violate or concel lhe provision of any other state oi local law regulating conslruction or Ihe performance of <br /> construclion. That I am auUiorized by the owner of ihis property lo pe�iorm Ihe work lor which applicalion is made end I comply with Ihe <br /> SI Contractors Law 1827 RCW and 296200 WAC !l,ap'T <br /> W tR 23 <br /> nati e ol O ien omractoriAuthorized gem ate �l� <br /> � <br />