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f <br /> � � �tRMIT APPLICATI�N <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 PAHCEL TAX I.D.p PERMIT <br /> I W �Ps�a�o �„p�'D - n ocrd651 D lol 6 '�D�- 3 � <br /> LEGA l0T NO. BLOCK TRACT OR SUBUIVISION M <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �oNlt.'2sE't" ��.k Cd�oorn�rJ;�Ms 143� WCps►� �v �ft�tC °i82a4 <br /> TENANT NAME CONGTA'CT FOH PERIM'IT, PHONE � fpdZ �I I <br /> SOMC'Q {� .�II��l11G�Y� FI��C�' ���-MaLJIMA�J�iuAE411Ql�7f. <br /> 't$b � <br /> CONTR.LICENSE N <br /> USE OF BUILDING I — HEAT SOURGE CONTRACT PRICE OF WORK <br /> CO��1�'���i�m Eleclric ___Uas_. _Ulhcr � �'���� �� <br /> WORK DESCRIPTION � <br /> �Z�t1E � �"'fl.l�6 S'��� R�F � T�LP� �►.lJ&�F P�1f't�MRS <br /> •, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIX fURE OR ITEM <br /> ToiIC� � . • • . • A�C-air handling uni15 �' , <br /> — p�����i�� � ' ' '` Forced air systems <br /> Lavatory �wash basin� _ Gas p�ping <br /> Shower _. Waler heator <br /> � Kilchen sink 8 d�sposal Gas lireplace <br /> Dishwashcr __ Gasrange <br /> Clothes washer Cloihes dryer <br /> Waler hea�er Range hood <br /> Sink (scrviccrbarimop olc.l __ .� Exhaust fan <br /> Dackllow preventer _ __ Heat pump <br /> Urmal _ Unit heater <br /> _ Drinking Founlain ______ Boiler <br /> Floor drain , __ Relrigeration <br /> Greasc irap - Woodstove <br /> -- <br /> Rool drains Oiher_________ <br /> Other _ __ -- <br /> _ _ _---- <br /> -- I - - - ----- <br /> CITY OF EVERETT LOCAL SALES TAR CODE IS 3105 <br /> I hereby cerilily ihat I have read and exai iined thi, application and know the same to be true and correct. All provisions ol laws and <br /> ordinaces goveming Ihis type ol woik will bo complied wdh whether specilied herein or not.The granting ol a permit does nol presume <br /> lo give authority lo violate or cancel the provision ol any other slale or local law regulating construction or the pedormance ol <br /> construclion. That I am aulhorized by Ihe owner of Ihis property to perform the work for which apphcation is made and I comply with the <br /> SI Can�raclors i-aw 18.27 RCW and 296200 WAC �jpp7 <br /> I� U� 23 <br /> nati e of O ier oMractouAuthonzed Agenl aite — — II� <br />