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PRIMIT APPLICAT1011 <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 PMC -069 —OS <br /> SITE ADDRESS --- PARCEL TAX I.D.# PERMIT# <br /> 2 '/ '7 � "ec s/ DOS,; 59 / 3®ce ot, // ' <br /> LEGAL LOT NO. /BOCK TRACT �/ / �+ ®/ <br /> DESC. 131--/.41 i/ 5 0 c1 -00 ride// �a/�d co J/1(]L "-cid <br /> OWNER ADDRESS' CITY/ZIP PHONE V2,5---2iU. y/ <br /> 6.4e Aa kat, 13a le k5 /o (9 ce ia/ Arte 141fysv,`i//. '7Flit 70 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> &AA ,'e / 3- -aii-1y 7 <br /> CONTRACTOR y o,!', p ( ADDRESS / 1C'CITY/ZIP PHONE n <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> 2 AedAa,to f e ATa / _Electric _Gas_Other a1 0 ©D <br /> WORK DESCRIPTION AeP`t e /DOR /2- 6Rok&A' ,gYv7/e Ph-/-"e w,'t-'ddal a/'• ?kits.'" <br /> 0).iocidlos • ci- 1 sKy lig Ar 9�,; � 7& sict .The- 'Ras : -&P/once O/d 7,8� <br /> gret <br /> .a, 5 < Re e.. k,• c' hep Gadi" <br /> y <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 1Toilet fewer ° ta. / A/C—airhandling units <br /> / ' Bathtub/54 7 I e.R. ���. ' Forced air systems <br /> / Lavatory(wash basin) ' ' .• ,. , Pe Gas piping <br /> Shower Water heater <br /> Kitchen sink.+8i-ctisposal ` Gas fireplace <br /> Dishwasher / Gas range <br /> Clothes washer Clothes dryer, fy�c ,N9 <br /> Water heater Range hood,,(e <br /> Sink(service/bar/mop/etc.) , Exhaust fa <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this t pe of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to vie. - e 'r cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.„�a0►( j . thorize• by the owner,of this property to perform the work for which application is made and I comply with the <br /> State ,Y �r 7: 7 and 296.200 WAC. <br /> Co4r'' <br /> ... <br /> ,Sign- ur- • •wner/Contractor/Au orized Agent Date <br /> ,x � <br />