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PERMIT APPLICA710N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER�.TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-w�vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI # ��� <br /> boai 23it° t�.. 41. ztoYoZoo o� go.� <br /> LEGAL LOT NO. BLOGK TRACT <br /> UESC. <br /> OWNER ADDRESS CITY121P PHONE <br /> Zibe a»GEr�ENr S�.vic�f3 f�YLS Su sw,ueEeA.ta sY Tia��ce,�?� 9�Zz3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> S wra�r IM i� (�-rn c Euc�cFr � ►"I icR►e�. A�►voa� �y2s �'fr1- 9r2y <br /> CONTRACTOR ADDRESS CITY/ZIP PH E <br /> vME�rMccrsKw��,rwc ��So is3��4�E NE �aM+own ( kP3-qu.y <br /> CONTR.LICENSE# �JYOSL <br /> M���rr,� 16� n_rh <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �M�Q��L I —Electric _Gas_Ot'�er 34� SOO,60 <br /> WORK DESCRIPTION=�/Sr�LI y V�V BQKES , 3 vvr zo�c p�►�,i�, /FIt� AMcft�.r.r/`��5� <br /> � '7 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FO(TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water healer <br /> Kilchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer � _ Clolhes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/bar/mop/elc.) � Exhausl(an <br /> Backflow prevenler ( _ Heat pump <br /> Urinal �' Unit healer <br /> _ Drinking Founlain �� Boiler <br /> _ Floor drain \� // Refrigeration <br /> _ Grease irap l/ Woodstove <br /> Roofdrains 3 Other vnu��,s <br /> Olher 3 wr 7� �rt�ca� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify Ihal I have read and examined Ihis applicalion and know ihe same lo be irue and correcL All provisions o(laws and <br /> ordinaces governing lhis lype of work will be complied wilh whelher specified herein or not The granling of a permit does nol presume <br /> to give aulhority to viclate or cancel the provision o(any other slale or local law regulaling construction or the peAormance of <br /> conslruction. That I am authorized by Ihe owner of lhis property to pertorm the work for which application is made and I comply with the <br /> State onlraclors Law 1827 RCW and\0 WAC. <br /> Si�re of O�on ac Aulhonzed A t Date �I <br /> Z <br />