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PERMIT 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 />SITE DR S h 1 <br />PARCEL TAX I.D. # <br />PERMIT # <br />i <br />Qo y L oo/o 00 <br />(� <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />I LIB' L Q <br />OWNER ADDRESS CITY/ZIP PHONE CJ 2 5 <br />I-e�o�c�NomeS �1V•1���- ij1(o-S.l_jk•3kevenS LP Skevens <br />�,4t� ass% , os �3 <br />TENANT NAME <br />CONTACT FOR PERMIT ONE <br />P <br />�25. <br />GVNn —1� C���(1 3 ' 051 <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />L,Ec-,ar.N�yy � <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />cJ� <br />—Electric _ Gas —Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />l <br />Forced air systems <br />Lavatory (wash basin) <br />�_ <br />Gas piping <br />1 <br />Shower <br />Water heater <br />Kitchen sink & disposal ' <br />I_ <br />Gas fireplace <br />L <br />Dishwasher <br />I <br />Gas range <br />Clothes washer <br />_I <br />Clothes dryer <br />Laundry tray <br />I <br />Range hood <br />I <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces 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 Contract s Law. 7 RCW a d 296.200 WAC. <br />�oao� <br />Signature of wner/ ntractor/Authorized Agent Date <br />