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F ;RMIT APPLICATIo.N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-wvuw.everettwa.org <br /> �(��� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S �a S'-�� <br /> SITE ADDRESS I M�r r�i� Creek PkwY PARCEL TAX I.D.# PERMIT# <br /> rcuereH- WN Rfip23 � �as• 03 <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. (_p <br /> OWNER � ADDRESS � CI IZIP PHONE <br /> U DR, �� ���� 5(�w Cox f�Oad , �u+e Zc� g�n Allen, VA C�D4� qlDS- ILI-OZ <br /> TENANT NAME CONTACT FOR PERMIT PHONE 253)4lc$- 1337 <br /> I ���,e MQeic�S e-Mai� mikc@macmorinc_.cnm <br /> Z`buf r 1.^iF�C U1ACi45 R fiTi - <br /> K��ma-, lnc. PD �oX q(��k C,��F (�+lXa; NJ�1 �253�z�3-8537 <br /> CONTR.LICENSE ��U <br /> l�'f F�C.N2 Q L%�q'y� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I _Electric _Gas_Other `�, (�� �7,Z,� <br /> � <br /> WORK DESCRIPTION <br /> ��oncfete �ork Gtnd {-'i�,�ninti p� gazebD <br /> �J <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink (service/bar/inop/etc.) Exhaust fan <br /> Dackflow prevenler _ Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain _ 8oiler <br /> Floor drain Refrigeration <br /> Grease irap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7�AX CODE IS 3105 <br /> I hereby certify ihat I have read and examined this application and know ihe same to be true and correct. All provisions of laws and <br /> ordinances governing this�ype of work will be complied with whelher speci6ed herein or nol.The granting of a permit does not presume <br /> lo give authoiity to violate or cancel Ihe provision o(any other slate or local law regulaling conslruction or ihe per(ormance of <br /> construction.That 1 am authorized by the owner of this property to perform the work for which application is made and�comply with the <br /> Stale Contractors Law 18.27 RCW and 296. 0 WAC. <br /> s /D <br /> I Si of O dCo ct itho d Agent D te — <br /> r�2 <br />