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� I�tRMIT APPLICATIbN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.�verettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.a� PERMIT / <br /> I o W �PS�a�� �aP�'D - I� 0�651 0 10l Q '�0�� > > <br /> [.EGAL LOTNO. BLOCK TRACTORSUBDIVISIONN <br /> C�CSC <br /> OWNEH ADDRESS CI7Y�ZIP PHONE <br /> ScML�-�E'1' �'J�.k Cd�oom�rJ��Ms 143� wCA51►� � �1t�itC °►82�} <br /> TENANT NAME CONTACT fOR PER1M'IT PHONE � be2 +�2�I <br /> SOMEQS�' �DRk �IIA�(qL' �Y� F�t��p�►+ �� `^-�.MaLJIM@�JPNACWIQlcTf. <br /> L`bATItACTa .�.�D ! <br /> CONI'R.LICENSE p <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> COI�tb1�1i►�f�fM� __ Eleclric _ __Gas ___Olher I � � �Q�� ��� <br /> 1 <br /> tiYORK DESCRIPTION <br /> �2�t(E ! €��E Slo� �F � P�l.P�n� Lf,jJ&-��` C�1�'t'In2$ <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM N0. TVPE OF FIXTURE OR ITEM <br /> Toile� . . • ' . . ' ,�__ A/C--air handling uni�'s - , � , <br /> Oath�ub " ' ' ' __ Forced air sysloms <br /> Lavatory pvash basm� ____ Gas piping <br /> � Shower ._,__ Watcnc�atcr <br /> Kilchen sink 8 disposal _ . G2s lireplace <br /> Dishwasher . ._ Gas range <br /> Clothes washcr Clothes dryer <br /> Water healer __ Range hood <br /> Sink(serviceibadmop elc.l _ _ Ezhaust lan <br /> _ Oxkllow preventer ___ Heal pump <br /> Urinal __ Unit hcaler <br /> Drinking Pountain ____ Boilcr <br /> Floor drain __ Refrigeration <br /> ___ Grcase trap . ._ Woodslovo <br /> ( Rool drams Other _ <br /> -- ---- <br /> Olher <br /> CITY OF EVERETT LOCAL SALES'�AX CODE IS 9105 <br /> I hereby cerdily Ihat I have read and examined ihis apphcation and know the same to be true and correct. All provisions ol laws and <br /> ordin�ces governing thls type ol work will be complied with whether specified herein or not. The granting ol a permil does not presume <br /> to gwe aulhoiiry lo violale or cancel Ihe provision ol any other stato or local law regulating construction o�the performance of <br /> construction. That I am authorized by the owner ol thls property lo perlorm Ihe wcrk for which application is made and I comply with tho <br /> SI Conlractors Law 1827 FiCW and 296 200 WAC. �jp'7 <br /> W (J� 23 <br /> nati e ol O iev onlractonAuthonzed Agent ate � Ilz <br /> � <br />