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( t <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- F,4X 425-257-8857-www.everettwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM , <br /> SITE ADDRESS PARCEL TAX I.D.q PERMIT , <br /> I W CPS��a�u �p��p - I� o�d651 D lol Q '�0�� �`) <br /> LEGAL LOT N0. BLOCK TRACT OR SUODIVISION K <br /> DESC, <br /> OWNER AUDRESS CITY2IP PHONE <br /> ��Rs�'I' {' Cd�oorni�l��Ms 143� �1CR5►►� �v �1�'cC °1820�} <br /> TENANT NAME CONTACT FOR PERMIT, � " PHONE � fp6Z T�L I I <br /> �'11I��StC �'ARk I J�N�IIL' PN� ��(purs� "^*`l - "E-MIUL�JIM('@�D�GJIYCW11DGrS. <br /> aar�z .,�,�D � �— <br /> CONTR. LICENSE N <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> ' � � n <br /> ���I�����m Elc�lric Gas ____Other ` �0�� � <br /> 1 <br /> WORK DESCRIPTION <br /> tZ�lct(E 6� R�R(�6 S��D� V� � f�LP�rYp Lf.(f��` R�t'k�R$ <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 7oil�t � , � , _ NC–�air h�ndling units � � <br /> Bathlub � � - ' _ Forced air systems <br /> L�vatory (wash bas�n� _ _ Gas piping <br /> Shower .,__ Water heater <br /> Kitchen sink&dispos�l . __ Gas fireplace <br /> Dishwashcr ___ Gasrange <br /> Clalhes washer _. � Clothes dryer <br /> Wa1ei heater _ _._ Range hood <br /> Sink(service!badmop'etc.l ..___ Eahaust fan <br /> � Oackllaw prevenler __. _ Heal pump <br /> � Urina! ___ Unilheater <br /> _ Drinking Fountain __ Boiler <br /> Floor drain _. Refrigeration <br /> Grease trap . Woodstove <br /> � Rooldrains _ __ Othcr_.___ <br /> --- Other – – --------- <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerAily ihat I have read and examined lhis applicauon and know the same ro be truo and coirect. All provisiqns ol laws and <br /> ordinaces goveming this lype of work will be complied with whether specilied herein ur not.The granting ol a permil does not presume <br /> lo give authority to violate or cancel tho provision of any olher stale or local law regulating construction or the perlormance of <br /> const«iction. That I am authorized by tho owner ol this property to perlorm the work lor which application is made anj I comply with the <br /> St Contrac�ors Law 1827 RCW and 296200 WAC. �jp'7 <br /> � U� 23 � <br /> nali e of O ieu ontradon�ulhorized gent ato � � <br />