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6A90� 20-' <br />PERMIT APPLICATION <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 r <br />Ci, ll� ��Je p' o1.Z <br />LEGAL L0T N0. BLOCI TRACT <br />DESC. <br />OWNER AUDRE <br />17.��15w. � ri,�(10�-v.a,,sveC��� <br />PARCEL TAX I.D. # <br />. .� <br />6 `�Q �-la <br />2MIT # <br />_/l�'�!1 <br />TENANTNAME CONTACTFORPERMIT PHONE <br />C,�Ec4.V`t,t�tV'e, I �1Pv�v�,r �opea/ a�-(a0g-�'� <br />CONTRACTOR ��� ADDRESS CITY2IP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />� <br />�� L i� � � r �� �_.• � ����\,�d <br />HEAT�OURCE <br />� Eleclric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />�5� ���� <br />WORK DESCRIPTION C�,� p� ��LS"E'� v�� C.eLI. �OCC7�V' �-� 1.y` lS S �� -� i <br />�a���� � ��� �� �� ��. w�,p��.v,,,k�, <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry Uay <br />Sink (servicelbar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firepiace <br />Gasrange <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Retrigeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereby cerilify that I have read and examined this application and know lhe same to be true and wrrect. All provisions of laws and <br />ordinaces governing is typ f work will ba complied with whether specified herein or not. The granting of a pertnit does not presume <br />to giv thoriry to vi�late or ca cel tha provision o( any other state or local law regulating conslruction or the performance of <br />w strucU n. That I a�t authoriz d by the owner of this property to per(orm the work for which appiication is made and I comply with the <br />cr�rn Cnn actors LawV827 R W and 296.200 WAC. <br />��Z <br />