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f�tRMIT APPLICATIbN <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 AD�RESS PARCEL TAX I.D.# PERMIT <br /> I W CPS��D �J,pp�'p - 26 ocr3651 D lol Q 70�- �f l <br /> L[GA LOT NO. BLOCK THACT OR SUBbIVISION N <br /> DESC. <br /> OWNER ADDRESS CITViZIP PHONE <br /> �Ls�'t {'ik�k CdJ�orn�rJ;�Ms 143a WCp�s►►� 1� �t�tC °182a4 <br /> TENANT NAME CONTACT FOFi PERMIT � " PHONE � �pdZ Tv�I I <br /> ��X CARk I JIIJ��NG�Y1. ��(�J� ""*`l "_`'�.MaLJIM@�DdlNfw'_4F�QlGS. <br /> �� .�.�D � <br /> CONTR.LICENSE N <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> (,G1�����}�m Eleclric Gas __O�hcr d ` ���� ��� <br /> 1 <br /> WORK DESCRIPTION <br /> 1��E � ��wE s�o�sc� tu� � n.�l.a'� �uJ�PF �a�rzs <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM NO. TYPE OF FIxTURE OR ITEM <br /> 7oilet , . • • � , � i -. '; . � � � Afi,-�ar handling units � � � ' • <br /> patMub forced air syslems <br /> _ . Lavatoiy Iwash basin) ._ _ Gas piping <br /> Shower _. Water heater <br /> _ _ Kitchen sink 8 disposal _._ Gas fireplace <br /> Dishwashcr Gas rangc <br /> Clothes washer _ Clolhes dryer <br /> Water heater _ Range hood <br /> ___ Sink (service;barhnop�etc.l ___ Ezhausl lan <br /> __ 8ackllow prevenler _ Hea�pump <br /> Urinal ___ Uni�heatcr <br /> _ Drinking Foun�ain _._ Boiler <br /> Floor drain _._, Relrigeration <br /> __ Greasc trap Woodstove <br /> Roo�drains ___ _ Other_ _ <br /> � OUier -- ------- -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 <br /> I hereby cerilily Ihal I have read and ezamined this application and know the same to be true and correct. All provisions of laws and <br /> oidinaces�oveming ihis type ol work will be complied with whether specilied herein oi not.The granting ol a permit does not presume <br /> lo give authority to violato or cancel the provision o�any other state or local law regulaling construction or Ihe pertormance of <br /> construction. That I am a��thorized by tho owner ol Ihis properry to perform the work for which application is made and I comply wilh the <br /> St Contraclors Law t.,.27 RCW and 296.2001NAC. �T <br /> l� (� 23 <br /> nau �e of U ieu on�ractouAuthorized Agent ate � <br /> . __ . _ _ _.----- - - ------ .- _._----. . .._—�---- -- / _} <br />