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.51 '. <br />� � , _ <br /> ra <br /> y, _— I <br />�, �� :� PERMIT APPLIGATf0�1 <br />� CITY OF EVERETT PERMIT SERVICES <br /> 3200 �EDAR STREET, EVERETT, WA 98201 <br />� 'r 425-257-881 C— FAX 425-257-8857 —v,�ww.everettwa.org <br />�5 � <br />, "�'�s A.PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> a • i <br />� ; <br />,� � a SITE ADDRES� PljRCEL TAX I,D.# PERMIT# �"; <br /> w ��;� '� I 1 l � •�<,�;-� - > �,. ; O ) � <br /> - � � �:._ r� ���„�. /.: �: ��. l� � o��o - �v 3 f <br />� i+ ��. LEGAL LOTNO. BLOCK TRACT <br />� DESC. <br />�� OWNER ADDRESS CITYRIP pHONE <br />� <br /> �.-� �,.I �i 1'`i �jlo�� C�•t" �"l n�O� Wi��y L�./_a'/.td� CT.S� �� <br /> TENANT NAME CONTACT FOR PERMIT � pHONE + � <br /> LC+ v <br /> (�t't���•{ \'o� D'r4N✓f t_.� G l:5`';;y� I P►—"1 Zvb lr/� �'j�30 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> ��-� (�`( l.U'� C.DL{: <br /> CONTR.LICENSE H <br /> USE OF BUILDING HEAT SOLir2C[ C NTRACT PRICE OF WORK <br /> �L'�� I �j j �J�r ��� _Elsctric _Gas_Olher SQ(j <br /> WORK DESCRIPTICN <br /> /� �,-''�,� `,;�,'�L� :.`, <br /> PLUMBING MECHANICAL <br /> N0. TYPG OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet A/C—air handling unils <br /> _ Balhlub Forced air system� <br /> _ Lavatory(wash basin) �as piping <br /> Shower iNater heat�r <br /> _ Kitchen sink 8 Aisposal Gas fireplace <br /> _ Dishwasher Gasrar.ge <br /> _ Clolhes washer Clolhes dryer <br /> _ Walerheater Rango hood <br /> Sink (service/badmop/elc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> � Floordrein Refrigeratio�i <br /> Grease trap Woodslov�+ <br /> Foof drains Other <br /> i Other — — ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> �hereby ceriti(y that I have read and examined Ihis application and know the same lo be true and correct. �\�I provisions oF laws and <br /> ordinaces governing this type of tvork will be complied wilh whelher specifiod herein or not.The granting of a permit does not presume <br /> to give authoriry to violate or cancel lhe provision of any olher stale or Iocal law regula6ng construction or the periormance of <br /> conslruction.That I am authorized by lho owner of this property to perform lhe work for which applicalion is made and I comply with the <br /> State Contraclors Law 18.27 RCW and 296.200 WAC. <br /> Signature o(OwnedConlractor/Authonzed Agent Date �I� <br /> \ <br />