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' ' ( + <br /> PER111�IT 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 /> PARCEL TAX I.D.# PERMIT t <br /> SITE ADDRESS � /"nz <br /> LEGA LOTNO. I �CK TRA�CCTORSU�IVISIONli <br /> DESC. <br /> ADDRESS CIIYlZIP PHONE <br /> 9w"�R�PvS f1�J (�0�a$eme'"�- cl►S lv�t-Ct.�-�e.Src. +*3ou �-N�-u� Q�0.5 _ <br /> CONTACTFORPERMIT PHONE <br /> TENANTNAME 5 nronb�fa�lcune• <br /> mp.r-c e_. ,SI'�nn� a��rx hc��n.� �..� <br /> CON�j ADDRESS CITYIZIP PHONE <br /> C�,ire �t�. s►� � sr n�J G��rzc� c,�'� 9�� `�� <br /> ONTR.LICENSE k �`, � �� S� <br /> V <br /> USE OF BUILDING HEAT SOURCE CONTflACT PRICE OF WORK <br /> /�! ,,,��,,,�^ �, f' ..�I _Electric �as_Other �I� �D. � <br /> L J�(1 V I�`�f�-1,��' <br /> �RK DESi RIPTION�✓1�t5 `�JI/1��M f� PUl��� �l �11 ClIS� 1� "'Cr 1'T�� ��" <br /> Y�plGl ��1�- U <br /> ���� � ��� ��� l MECHANICAL <br /> PLUMBING <br /> NO. 1YPE OF PIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel ,� aC-air handling units <br /> _ Forced air systems <br /> Bathtub Gas piping <br /> Lavatory(wash basin) Water heater <br /> _ Shower Gas fireplace <br /> _ Kilchen sink&disposal Gas range <br /> Dishwasher Clothes dryer <br /> _ Clothes�vasher Range hood <br /> _ Waler heater Exhaust tan <br /> _ Sink(servicelbadmop/etc.) � Heat pump <br /> _ Backflow preventer Unit heater <br /> Urinal — goiler <br /> _ Drinking Fountain Retrigeration <br /> Floor drain Woodstove <br /> Grease trap Other <br /> Roof drains — <br /> Olher_ — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritily ihal I have read and examined this application and know the same to be We and correcl. All provisions of laws and <br /> ordinaces goveming this type of work will be complied wi�h whether specified herein or noL The granting of a permit does not presume <br /> to give authorily to violate or cancel ihe provision of any c,lher state or Iocal law rec�uiating consiruction or the perlormance of <br /> conslruc' n.That I am authorized by the owner ot Ihis property to perlorm lhe work for which application is made and I comply with the <br /> Stat ractors i.a� .27 CW and 96.200 WA0. � O^ <br /> 0 <br /> Sign ur ot Owner ontr or/Authorize genl 1e /.� <br />