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� <br /> �- P`�MIT A�PLICATIVfV <br /> CITY OF EVER�TT PERMIT SERVIC�S <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 - DEBIT& CREDIT CARDF. ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> SS� Fvfn�rLEc-�✓ r,.�,� � _ C �� I <br /> LEGAL LOT NO. BLOC 7RACT � <br /> DESC. � <br /> O�YNER ADDRESS CITY/ZIP PHONE <br /> TENANT NAME CONTACT FOR PERMIT P OPIE <br /> r-�'1�n�2�s� ap✓1 A- c�2 sr��✓F F�tu�✓ 2�� 282-�tao <br /> CONTRACTOR �/�-�jy�/�L S�6/� lG . ADDRESS CITY2IP' PHONE <br /> rzss �sTi�,wE n�� sFa�� 9s��9 f2�) �gZ��`� <br /> CONTR.LICENSE# �,/'q�,.fc�31M3 '% /�3/�� <br /> USE dF BUILDING / HEAT SOURCE CO TRACT PRICE OF WORK <br /> O�r''��� /�r� S•�L�j ._Electric _Gas_Other �p�0� <br /> WORK DESCRIPTIO� <br /> I..i)1R�+-1 -/�✓o r(,�uwt 6u�c�r�6 sic�✓S ��F04qcFf .Z w,p-t�L Si6� <br /> A,t,3 p ��31R+Z r�✓C r✓e't'/ D�� 3�ir✓ f-1t1/r�F� d,�✓ �X/;!/,✓� Q�JI.�✓ f'�!�✓ s./�t�lu+tF ) <br /> /'rcty/FS /ZFmrnrL � Eq3fji✓61/ �/ <br /> PLUMBING MECHANiCAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C—air handling units <br /> Bathtub _ Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink (service�badmop/etcJ _ Exhaustfan <br /> BackFlow pn:venter _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain 8oiler <br /> Floor drain _ Refrigeretion <br /> Grease lrap _ Woodstove <br /> Roof drains _ Olher <br /> Qther <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br /> I <br /> � I hereby cerilify th have r and examined this application and know the same lo be true and correct. All provisions of laws and <br /> ordinaces governi this ty �(work will be complied wilh whether specified herein or not.The grantinq of a permit d�es not presume <br /> to give authonry t iolate ancel lhe provision of any other state or locai law regulating construction or the performanc.e of <br /> construction.That am 2u rized 6y the owner of this property to perform the work forwhich application is made and I comply with the <br /> Stale Contractors ' 18 RC �and 295.200 WAC. <br /> �' � <br /> � �� <br /> Signature of Own r/ 'ontra dAuthonzed Agent Date <br />