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�RfIIAIT APPLICATIUN <br /> CITY OF EC�'ERETT PERMIT SERVICES <br /> 3200 CEDi,R STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.orc� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S -Z-B�Q <br /> SITE ADDRESS _ � ,.,'��x� PARCEL TAX I.D.� P RMIT M <br /> j� LW � ��aa5 <br /> LEGA LOT NO. 6L0 TRACT OR SUBDNISIOH 8 <br /> DESC. <br /> OWNER ADDRESS ^ CITY2IP PR``NE _�3CJ.f(� <br /> ♦ K� <br /> _�I Z G �2C.�� � CV��2�''T7— v�' r <br /> TENANTNAME CONTACTFORPERMIT PHONE �����' ,� <br /> �� 1����r ��A���3�>��s ,�� C�;��� �,��- rr�,es,ar�� E-�N� <br /> -��NTkA� 6RE�5 <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CON7RACT PRICE OF WORK <br /> I �Electric _Gas_Other <br /> W�JRKDESCRIPTION ,J��C/�� �� N�S �� G'ON'1/�1l/��(/�Lat� �- ��"/ <br /> `� of�v���rz Ol�Nnr.�-��r <br /> �/IUi��2� CI-v '�GCa�m�l- -��1� �J (.l�f�17`6✓lS" !��'��> t�c�lj'���1 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel _ NC-air handling units <br /> Bnthtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Walerheater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher __ Gas rango <br /> C'othes washer __ Clothes dryer <br /> Water heater __ Range hood <br /> Sink(service/bar/mop/elc.) _ Exhausl tan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Reiriyeration <br /> Grease lrap _ Woodslove <br /> Roof drains — n��"'� - <br /> Other — -�- - - - <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritiFy that I have read and examined this application and know lhe same to be true and correcL r.11 provisions of laws and <br /> ordinaces goveming lhis typo of work will be complied with whelher specitied herein or not.The grenting of a permit doos not presume <br /> to give authoriry to violate or cancel lhe provision o(any olhcr stale or local Iaw mc�ulating construction or the peAormance of <br /> construc' n.That I am aulhorized by the ow ot lhis property lo pertorm the work for which application is made and I wmply wilh the <br /> Stale C Iractors Law 18.27 RCW an 2 . 0 WAC. <br /> /` � � ��- o,s�a� ��� I <br /> ' I t e o(Owner Co lraclor/Authorized Agent Dale (/v <br /> � <br />