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P��MIT AP�PLICATIG�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS � �i. C«�il �p�,` �RC L TAX I.D.p PERMIT it <br /> �� � " � `� � �U.501' �q <br /> � ,� � � �, i i� <br /> LEGA LOTNO. BLOCK TRACT ' <br /> DESC. <br /> OWNER ADORESS CITY2IP PHONE <br /> ��U���� �v�C 1�203 S�, 24R�h S� LlP�ifi qF�030 2s3-SS�(63 7 <br /> TENANTNAME CONTA�°,�` ERMIT PHONE <br /> ��v i���r� � �- �.53-vSk -G3s -7 <br /> CONTRACTOR ADDRESS�— CITY2IP PHOtIE <br /> OWw �. � <br /> CONTR.UCENSE p I�� S <br /> 3 E �4�' S7 Kch�q�0 2s3-�/-43s' <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � � � ; , I �Electric _Gas_Other �� �Q 0 /F(�r����07 � <br /> WORK DESCRIPTION <br /> ����� <br /> �Nu���r� Slor���c� rocjh� 'i'a .��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—atr handling units <br /> Bathtub Forced alr systems <br /> Lavatory(wash 6asin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas flreplace <br /> Dishwasher Gas range <br /> Clathes washer Clothes dryer <br /> Laundry tray Range hood <br /> I = Sink(service/badmop/etc.) = Exhaust fan <br /> Dack(low preventer Heet pump <br /> � Unnal UNlheater <br /> � Dnnking Fountain Boller <br /> i _ Floor drain Refdgeralion <br /> Grease trap Woodstave <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA7(CODE 19 J10S <br /> I hereby ceritity that I hava r.,ad and examined Ihis appiicatlon and know the same to be true and correct. All provisions af laws and <br /> ordinaces goveming lhls rype o(work will be complied�Nith�.vhether speci(ed herein or not.The granting of a permit doea not presume <br /> lo give authority to violate or cancel the provision of any other state or local law regulating construction or the performanco ot <br /> construction. That I am aulhorized by the owne of this property to perform the work for which application is made and I comply wilh tne <br /> � ilate Co�,tr�ctpr . 7 RC d 29 AC. <br /> ��/ ' / � _ <br /> igna ure n ractonAuthonzed ent ate <br />