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( PERMIT APPLICATION �`���7� s z��`� <br /> CIT'f ^'� EVEREI'T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � 7Q 7 '� - <br /> 425-257-8810 -FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a / <br /> _ / <br /> SITE ADDRESS PARCEL TAX I.D.# `_ P RMIT# <br /> 860 �✓ .��., c�a 2aoyr3ooio 0o a`� - l � <br /> LEGAL LOTNO. BLOCK TRACT �- � <br /> DESC. ...-- .� Se� �{'F'.�1f�1�' 1� .L�SC/'/ �fO�J <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Gommdrti'� f�an(th �CN�2Y' <br /> TENANT NAME CONTACT FOR PERMIT TQy��,,.G�Q90„� PHONE <br /> 5��� I Chr�s/,a7 car�ng�•.��ttm-��eld �rr,�,�fe�F� Yr,c�77s'•is3 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> �'f� . Ik�bo�`Cony/7vr.fioq ?S72 ��'�°��' W�7 S. 5e4ffle �206) 967- SSDo <br /> CONTR.LICENSE# Lf��� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> a'�IYllql'�'�'I7.ff►6 ��itP� _Electric 1�Gas_Other � C�g (0 7z(� <br /> WORK DESCRIPTION <br /> �� <br /> ��mnl� sl-� ��� � ��I�-��� <br /> PLUMBING ..�,� ��/� MECHANICAL - ,pes/ y_/ <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR REM ���u <br /> �/ Tc.ilet A/C–airhandlingunits <br /> Balhtub Forced air systems <br /> H Lavalory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> � Dishwasher asrange <br /> othes washer C hes dryer <br /> La dry tray _ Ran hood <br /> 1 �ink( ice/barlmoplelc.) exhaus n <br /> Back(low venter Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Greasetrap Woodsrove <br /> Roof drains Olher <br /> Other <br /> _ —I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> t 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 /> ordina:es governing this type of work will 6e complied with whelher specified herein or not.The grenting o;a permit does not presume <br /> to give authority to violale or cancel lhe provision of any other slate or local law regulating consiruction or the performance of <br /> conslruction. That I authorized by the owner of lhis propeAy to pedorm lhe work for which application is made and I comply with the <br /> State Contractors w 1 CW and 296200 WAC. <br /> $ � O-7 <br /> SignaWre of O r/Coi r or/Authorized Agent Date <br /> y. _-- <br />