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/ <br />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 ADDRESS ��3 � TT�= ,e-LvE !� PARCEL TAX I.D. # <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP <br />�j �4 / Ir2 �-=7�-� �72 G2 LSG.S <br />TENANT NAME � CONTACT FOR PERMIT <br />PERMIT # <br />�S%' i i� <br />PHONE <br />PHONE <br />CONTRACTOR ��NSUN PL,U�YII�/� ADDRESS CITY/ZIP PHONE <br />�--43 3 u �z`�,��- .� !ou - <br />CONTR. LICENSE # }�--1/� rc/ � �� L����� 4t U,3-'7 jL(,� Z <br />/20 �3�N P�- z�zc z 4 kZz'3 <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />ST=,� <br />Electric Gas Other � 3 Z CT'U <br />WORK DESCRIPTION <br />/N S /��'�-C <br />S F� <br />�./2 E SP,e. �,../�rc c. r�,s i°�� �v �=,�.4 / 3,� i.� ,�/ <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />�; [i� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />JPi2i N,r[ c_t�25 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. Ail 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 Contractors Law 18.27.RCW and 296.200 WAC. <br />ign <br />nt <br />