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� <br /> PERMIT APPLICATION <br /> CITY OF EVERET?' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 <br /> 425-257-8810– FAX 425-2E7-8857–www.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM '_, � -. , , . �,� , <br /> SITE ADDR •�jS PARCEL TAX I.D.M I PERMIT p <br /> 41 � �O wa � �'t f�' ��— <br /> LEGAL LOTNO. BLOCK TRqCT / <br /> GEEC. <br /> OWNER ADDRESS <br /> R cm�-�I�e✓� �C.E E re ri� WA <br /> �a��-� 36�� � 1��`�S � � L a�l � ��c < <br /> TENANTNAME I CONTACTFORPERMIT �i�- pHON��� ' <br /> �Q��.:a P1az� _ <br /> CONTRACTOR J fy �Ve� �%(P � c�Sp��� CITYlZIP PHONE t��'�5_ 7'76- 3 <br /> J l <br /> CONTR.LICENSE# �-]�� � I,_ _.. I _S�\ `n U <br /> / '1"uv v'� r \(7� � � ✓��� (/1��G1'cS'�c� <br /> USE OF BUILDING HEAT SOURCE ONTRACT PRICE OF WORK <br /> I _Eledric _Gae_Other ���-�-'�(� <br /> WORK DESCRIP710N i <br /> �s-��f--�-��--1�-�i-��–�;�-��1��—��� � � , <br /> � LVS����S�N�CG� 1rDD I <br /> l'� f�, ��-_ — -�,� S/��` , � <br /> PLUMBING IVfECMA{,pCAL____� <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> _ Toilet A/C-airhandlingunits <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> _, Shower _ Water heater <br /> _ Kitchen sink 8 disposal _ Ges firepiace <br /> _ Dishwashor Gas renge <br /> _ Cbthes washer _ Clothes dryer <br /> _ Laundry tray Renpe hood <br /> _ Sink(servicelbar/mopletc.) Exhaustlan <br /> _ Backflow preventer Heat pump <br /> _ Urinal UNt heat�r <br /> _ Drinking Fountoln Boiler <br /> _ Floordrain _ Refrigera6on <br /> _ Grease Uap _ Woodelove <br /> ,_ Roof drains _ Other_ <br /> _ Other ' <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310. <br /> I hereby ceritiry thet I have read and exemis�ed this�pplicetion and know lhe same lo be We and corted. Atl provisions of laws and <br /> ordinaces goveming this type ol work will be compl�ed with whether specified herein or not.The grenting of e pertnil does not presume <br /> to give authonry to vielate or cancel the provision of any other atate or local law regulating construction or the performance of <br /> consiruction.That I am authorized by lhe owner of lhls property lo pertortn the work for which application is made and I comply with the i <br /> Stat ontractora�1B.2�nd 298.200 WAC. <br /> Signature o w'ner/ ontractor/ ut onze gent `�l`I I��'e— <br /> �„l ,) <br />