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PEh2MIT APPLICATION <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 4 pM <br /> SITE ADDRESS Q",, PARCEL TAX I.D.tl PERMIT JI <br /> �Lp P�(�c4�1' ��CcU�-Or `-I <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNEF ADORESS CITf21P PHONE <br /> TENAN''NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADD ESS CITY2IP PfiONE <br /> N�,�v ��u�*�r� 1�l���, �o� R�ck� l5 8-� Vv�vrolt�vr�i1.. ��o ��:S 7 �(�'�2-- <br /> CONTR.LICENSE# Nc.w�PL �.SSNC� <br /> USE OF BUILDING — HEAT SOURCE �CONTRACT PFICE OF WORK <br /> Eleclric _ _Gas Other ��� ��,n�— <br /> WORK DESCRIPTION <br /> ����D7C1 <br /> �,. <br /> PLUfJIBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR 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 /> I� Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clofhes dryer <br /> Waler healer Range hood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> Backflow preventer __ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease lrap Woodslove <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritify that I have read and examined ihis application an�i kno�v the same to be lrue and correct. All provisions of laws and <br /> ordinaces c�oveming this type oi work will be complied with whether specified herein or nol.The granting of a permit does�ot presume <br /> to give aulhority to violate or cancel the provision of any other state or Iocai law regulaling construction or the peAormance of <br /> conslruclion.That I am aulhorized by Ihe owner of this property to perform lhe work(or which application is made and I comply wilh Ihe <br /> Statercontractor aw 8.271ZCW and 296200 WAC. <br /> �� 11 <br /> ��� � �Y <br /> S�q Wre o�OwnedConiraclo u onze ent Dale <br />