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PERMIT APPLs��TlO(V � � ; <br /> _ ; <br /> CITY JF EVERET7' FEi�MIT SERVICES � <br /> 3200 C�DAR STREET, EVERETT, VVA 98201 <br /> 425-257-8810- FAX 425-257-885'-www.everettwa.org <br /> APPLICATIONS ARE ACCEPT[D FROM 8 AM TO 4 PM <br /> SITp-E ADDRESS PARCEL TAX I.D.# PERMIT# <br /> I_] �b ��S�r S� (JC..Z- <br /> 1�1(>iG- <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# � <br /> DESC. <br /> OWNER � ADDRESS CITYIZIP PHONE <br /> �'� 1�c,r��oj,�,K�. f <br /> TENANT NAME GONTACT FOR PE1�RMIT PHONE S 4 I -'7k ��-7 i s-�1 <br /> I 1` � 1 FJC.�� �I�Sc,� J ��� � I <br /> � ; � �c�.^ckI 'F" E-MAIL,�I�SU��.S��'�',Lk�f1T"+(�.wrl <br /> CONTRACTOR ADDRESS CITY/LIP PHONE <br /> CONTR. LICENSE# <br /> t;dE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK . <br /> I��`�J, ,,,;,,� � i3 al� ✓Electric �Gas_Other <br /> WORK DESCRIPTION <br /> � <br /> OLJ �i�,v.C�f � .tJ"�`ifli�'�t � i,�w�� � <br /> PLUN�BING MECHANICAL <br /> IJO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling unils <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower _ Water heater <br /> Kilchen sink &disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br />`� Water healer Range hood <br /> Sink (serdice/b�r/mop/etc.) Exhaust fa� <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boller <br /> Floor drain Retrigeration ' <br /> Grease trap Woodstove <br /> Roof dra�ns Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> — I <br /> I hereby certify lhal I have read and examined this spplicatiun and know lhe same lo be true and correct. All provi>ions of laws and <br /> ordinances goveming ihis type o(work will ba complied with whelher specified herein or not.The granting cf a permit does not presume � <br /> - to give aidhoriry to violate or cancel the provision of any other slate or local la�v regulating construction or Ihe peAormance of � <br /> conslruction. That I am authorized by ih��owner of this property lo perform the work for which applica�ion is made and I comply with the <br /> State CoNractors aw 18.27 RCW and 29d200 W�C. <br /> _�M �1�"Lq�Z�io <br /> Signalure of OwnedCo tractor/Authorized Agent Dale t <br /> /� <br />