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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />Cj ' I CI -U 5 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />6`l19 Et-erfrec,✓ <br />PARCEL TAX I.D. # <br />0034729OOS-0 000 <br />PERMIT # <br />s - <br />LEGALI LOT NO. BLOCK <br />DESC. <br />TRACT <br />OWNER ADDRESS CITy21P PHONE <br />R (i�/ �4ai 12g1.o ti.} `•. 3V14 &I l 4� __ SueJ. Ca <br />TENA NAME <br />gi Q elIn'g 89a <br />CONTACT FOR PERMIT PHONE <br />5f-c.ve /7L0? k L(ZS 724­$3S- <br />CONT ACTOR Pe-r/ 11rCoN Co <br />CONTR.LICENSE# 13.rr�rrvco77ck. <br />ADDRESS CITYIZIP PHONE <br />LtiCf[.F,F (,uc} �7((Zo3 <br />USE OF BUILDING <br />,00 <br />f�'SirA�� <br />I <br />— HEAT SOURCE <br />Electric Gas Other <br />— — <br />I CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />/NSiALL (/) wftl <br />513AJ uOna�* Sr✓,✓ <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. 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 tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />I <br />A/C -air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerilify that I have read and examined this application and know the same to beirue and correct. All prc 'sions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of��this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW ar1d23ti3r7lTWAC. _. <br />