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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 —wv�tiv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT <br /> I W CPs�a�o �p��p - 2v o�6s1 D lol a0 /� '70�- �3 <br /> IEGA LOT NO. BLOCK TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADORESS CITV/ZIP PHONE <br /> ScMr�Ser �i�.k CENoorn�r���Ms �430 �JG�S►►� 1� �f�r�tC °�2� <br /> TENANT NAME CONTACT FOR PERMIT PHONF � (062 �62I1 <br /> �SCI� CDRk I ��1��IIG�Y� �t�l$1� �� ' "'E-MAIL�JIM@1�JFNAE�M�QY7S. <br /> caNrab+. ..�.�D ��— ; —�rb,�-- <br /> CONTR.LICENSE p <br /> USE OF BUILOING I — HEAT SOURCE CONTRACT PRICE OP WORK <br /> COI�������m Elec�ric _ ,_Gas OU�er � L ���� �— <br /> ( <br /> WORK DE3CRIPTION <br /> k�N�fE � �l'�A�E sio»Y� � � t�La'� �uJ&APE R�'r'n�rzs <br /> PLUMBING MECHANIr,AL <br /> NO. TYPE OF FI%TURE OR ITEM NC�. TYPE OF FIXTURE OR ITEM <br /> _, Toil�� � , .' , � � , ' •' , , , ___ FVC 7air handling units • <br /> g�����i�� __ Forc� air systems <br /> _ Lavatory(wash basin) , _ Gas piping <br /> -- Shower ___ Watcr heatr,r <br /> Kitchen sink 8 disposal . _ Gas lireplace <br /> Dishwasher _ __ Gas rangc <br /> Clolhes wnsher _ . � Clolhes dryer <br /> Water heater Range hood <br /> ____ Sink(serviceNadmop�elc.l .. � Exhaust fan <br /> _ Backllow preventcr .____ Heat pump <br /> Urinal __ Uni�heater <br /> _ Drinking Focntain ___ Boiler <br /> Floordrain ._ Nelrigeration <br /> Grcase trap Woodstove <br /> Rool drains Other______ ___ <br /> Olher -- ------ <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 9105 <br /> I hereby cerilify Ihal I have read and eMamined Ihis applicaiion and know Ihe same to be true and correct. All provisions of laws and <br /> ordinaces goveming this lype ol work will be complied with whether specil�ed herein or not.The granting cl a permit does not presume <br /> io give authority to violale or cancel the provision ot any elher slate or local law regulaling consVuction or the• �rlormance ol <br /> cons�ruction. That I am authorized by the owner ol this property lo perlorm Ihe work lor which application is���ade and I comply with the <br /> St Con�raclors law 1827 RCW and 296200 WAC. �jap'T <br /> W [� 23 � <br /> naU e o�O ier� onlractonAuthonzed Agent atc �/� <br /> ----- \� -- � <br />