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ZS��°'`�'"' P��ZMIT APPLICATIG.� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3'L00 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> /��`��� AFPLICATIONS ARE ACCEPTED FROM B AM 1'O 4 PM ��) 3,��� <br /> / <br /> SITE ADDRESS PARCEL TAX I.D.# PEg►�IT p <br /> '„fo2 71/ �. :5 100�1��3 <br /> LEG� LOT N0. BLOCK TRACT OR SUBOIVISION M <br /> DESC. <br /> OWNER ADDRESS � CITYIZIP PHONE Lj-Ul'LZ/ <br /> �A�fuT ����65 3726 3l��,y' 30/ C�ut.tt�/ 4/A , �ta•.i <br /> � <br /> TENANT NAME CONTACT FOR PERMIT PHONE�,%�.�l,�j <br /> /}(,L O�l !� � /�G � G'��/�K�S E•MAIL/�'!�(✓lC��� . <br /> Z`'BR�fjlt� 77R�������� .�Q �(Z� A D I <br /> CONTR�CENSE p �NS( '`• <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �7�� % <br /> �l ZZA %��-� _Eleciric �Gas_Olher yj`�' <br /> WORK DESCRIPTION �(/jyT �,�/f,�i�/�H� � ���-!.✓'b l'� Lt/1fY(�j <br /> �uf-,2,t� L l�c�.S .�+-.�e N /f�sn c^- �.a,�o . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYP[OF FI%TURE OR ITEM I <br /> Toilet A/C -air handling unils <br /> Dathtub Forced air systems <br /> Lavatory pvash basin) Gas p�ping <br /> Shower Water heater <br />� Ki�chen smk&disposal � Gas lireplace <br />� Dishwasher Gas range <br />' Clolhes washer Clothes dryer <br /> _ Waler healer Range hood � <br /> Sink(service/badmoplelc.) [xhausl fan <br /> Backllow preventer Heal pump i <br /> Urinal Unit healer - . <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease Irap ' Woodstove <br /> Roof drains Other <br /> Olher <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby certify that I have read and examined this application and know lhe same to be true and correct. All provisions o(laws and <br /> ordinances governmg ihis type of work will be complie ith whether specdied here�n or not The granling ot a permit does nol presume <br /> to give aidhority�o violate or cancel the provision ny ther slate or local law regulating cons�niction or the performance of <br /> conslruction.Thal authorized by e owner �lhi roperty lo perlonn the work(or which application is made and I comply with�he <br /> Stale Conlracto Law 1$�27 RCW d 9620 W . <br /> / � <br /> SignaWre of Owi dCoMractoqAuthorized AgeN Date <br /> I /� <br /> - — - -- - -- ----- ---- -- � <br />