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PERMlT APPLICATION I <br /> CITY OF EVERETT ryERMIT SERVICES � ✓a�_�v <br /> I, 3200 CEDAR STREET. EVFRETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org , � � ,n`�{� <br /> II APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 P�A / ��v <br /> — P MITN <br /> � SITEADDRESS 7.300 Kasch P+�rk l:d % PARCELTAXI.D.p <br /> I <br /> =�;�� 2t��0�1] d00203`�00-28041.90020363��0 �)� � <br /> ��IILEGAL LOT NO. BLOCK TRACT OR SU6DIVISION# <br /> oesc. Seccion 19 , Township 28 M, Ranye �1 East Vd.M. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> � ominuni ' y 'Cr��i�siL "!] 00 H:�tdc^on Frl Ever�tt [9:A 982D3 �25-3�18-2312 <br /> � TENANTNAME GONTACTFORPERMIT PHONE �1�5-3'18—�393 � <br /> I Ii/A � ],:,rr�� li.���l.�.nm�re <br /> E-MAIL I <br /> CONTR�CTOR AODHESS CITY/ZIP PHONE <br /> , CONTR.LICENSEp IIiC3 DOCllftl�iltG — '_���Iit.La�'tbt �s 'P. B.D. �� <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK I <br /> � . ;dr � �'.r�nonr � E'acili.ty I;si im :� _ ; L0 . '-�6i <br /> Flectric Gas Olher I� <br /> WORK DESCRIFTION , �' � � <br /> �� S�� � !�r' a', 0D�f/°t <br /> ., . ,,t i �:,�ir��; <br /> PLUMBING MECHANICAL Ii <br /> ryp TYPE OF FI%TURE OR ITEb1 <br /> ��p. TVPE OF FIXTURE OFi ITEM __ <br /> ' Toilet .____ AiC—nir handlin9 unils <br /> 8athtub . _ _ Forced air systenu , <br /> Lavalory(wash b�sinl _ Gas pipin9 � <br /> -- � Water heater <br /> Sho�ver � Gas fireplar.e <br /> Kilchen sink R disposal � Gas range �' <br /> . _ Dishwasher - � Clo�hes dryer i <br /> __ Cio�hes washer q�nge hood �' <br /> __ Water heater Exhaust fan I <br /> _ Sink(service,Uacmop�e�c.� — Heatpump <br />� Backllov+prevente�� - Unithealer <br /> Urinal - Boiler <br /> _ Drinking PouNnin �� Relrigeraiion <br /> _ Floordrain - Woodstove <br /> _ Grease Irap Other____ —_ <br /> Roof drains -- <br /> Olher -- ---._ — --- - <br /> tITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby ceritily Ihat I have read and examined�his application and know Ihe same 10 be irue and correcL All provisions ol laws and <br /> o�dinaces c�oveming Ihis rype of work will be complied with whether specified herein or noL The 9ranling of a permit does not presume <br /> ro 9ive au�horiry�o violate or cmir.al Ihe provision of any o�her staie or lor,al law rc9ulatin�conslruction or�he perlormance of <br /> ronsi clion. That I am nulhoiized by Ihe owner ol�his properry to perfonn the work lor�vhich application is made and I compiy wi�h Ihe <br /> ;ial �C n�raclois Law�7�Q:W end 296200 WAC. <br /> �,� 6 -z3-o9 <br /> �:up,ri urc of�_ mcrConli�clon/lulhonzed A9en� ���� �� <br /> Z <br />