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Ptr2MIT APPLICATIG�� <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 ACCEPT=D FROM 8 AM TO 4 PM <br />� SITE ADORES � PARCEL TAX I.D.!1 PERMIT# <br /> � 2� Z� <br />� LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N � <br /> DESC <br /> OWNER , ADDRESS CITY2IP PHONE <br /> ��'����Z�,.e�t� <br /> TENANT NAME�, , CONTACT FOR PERMIT � PHONE <br /> (, C�V L �`�� E-MAIL <br /> R ITY2 <br /> CONTR.LICENSE N / 1�n��I n �I/ // {�J� <br /> ��L7 / �L�«/ �' <br /> USE OF BUILDING " HEAT SOURCE � CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> i — _ — <br /> WORK DESCRIPTION � � <br /> ��h'IQ"-�� � // �1�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM MO. TYPE OF FIXTURE OR ITEM <br /> _ Toitet A/C–air handling units <br /> Bathtub Forced air systems �� <br /> Lavatory(wash basin) Gas piping ' <br /> Shower � Water heater '� <br />� Kitchen sink& .sposai � Gas fireplace . <br /> Dishwasher Gasrange . <br /> Cbthes washer � Cbthes dryer - � <br /> _ Water heater Range hood <br /> I Sink (servicelbadmop/e1cJ _ Exhausifan <br /> BackBow preventer Heat pump <br /> I _ Urnal � = Unit heater <br />` Dnnkmg Fountain Boiler <br />�� Floor drain Rehigeration � <br /> _ Grease irep Woodstove � <br /> _ Roof drains _ Other <br /> I Other <br /> — —i <br /> , CITV OF EVERETT IOCAL SALES TAJ(CODE IS J105 <br /> I hereby certify that I have read and examined this application and know ihe same to be true and corved. All provisions ot laws arW <br /> ordinances governing this type oi work will be complied wilh whether specified herein or not.The granting ot a pertnit dces not presume . <br /> to give authonty to vidate or cance!the provision of any other state or local law regulating construdion or the peAormance oi <br /> construction. That I am a�ihori �by the owner of this propeAy to pertorm the work for which application is made and I comply with ihe <br /> State�ontrador Law 27 C and 29 . 0 <br /> � Z' —D�. <br /> igna re o wner on racto Muthonze Agent Oate <br /> �-- _ — I <br />