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�tRMIT APPLICATI�N <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 1 PM �_ � 9—O' <br /> 317E ADDRESS PARCEL TAX I.D.� PERMIT t <br /> /�/,� rD � <br /> LEGA LOT NO. BL K TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PMONE <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ��^ja'f � � • ADDRESS,dpX�3y�' C��ITY2IP PHONFs, �ig, n.l� <br /> /�/IS�IO�✓ ��1� �r <br /> CONTR.LICENSE M ^�NT��S ��� /� � G?-�sZj <br /> � �� 7o�iiri <br /> USE OF BUILDING � — HEAT SOURCE I CONTRACT PRICE OF VNORK <br /> Electric Gas Other <br /> WORKDESCRIPTION �� /;� J L,r� <br /> /�c'i+-.o�e� »' �°�f �` <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE Olt ITEM NO. TYPE OF FIXTURE OR ITEM <br /> / Toilel A/C–air handling units <br /> Bathtub Forced air syslems <br /> � Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> � Kitr,hen sink i..cusposa4- _ Gas tireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> � Wale(healer P ) � �� = Rangehood <br /> Sink service/badmo /etc. �' .W S Exhausl tan <br /> 6ackflow preventer _ Heai pump <br /> Urinal _ Unil heater <br /> Drinkiny Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodslove <br /> Roo(drains _ Olher <br /> � other a 6 �" MS _ <br /> _L t. e _ <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify thal I have read and examined this application and know the same to be lrue and conect. All provisions ot laws and <br /> ordinaces�oveming this rype of work will'oe complied wilh whether specified herein or not The granting of a pertnil does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulaling construction or the peAormance oi <br /> construclion.Thal 1 am authorized by the owner of lhis propeAy to perform the work for which applicalion is made and I comply with the <br /> Slale Conlraclors Law 18.27 RCW and 296200 WAC. <br /> Signature of Owner/Conlraclor/Authonzed Agent Date <br />