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PEKMIT APRLICATIOIv <br /> CITY OF EVERETT PEF'MIT SERVICES <br /> 3200 CEDAR STREET, EVEkETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-wmnv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRES/S/ PARCEL TAX I.D.# PE�IG# O1 5 -v 3� <br /> ?j�'// /� />i�o.i��t.r/� <br /> LEGA LOT N0. BL CN TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNE� � � �, ADDRESS CITY2IP PHONE �yzS)ZSy <br /> � <br /> } �c. er v � 3So 9 ��oa u%a. �v�re� yS�'z ,�� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I �i� � �erv�f� , �y2S)15�'-6�75- <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE# ���`�� � <br /> USE UF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _EleGric �Gas_Other <br /> WORK DESCRIPTION / �/ �/J A ec4/ <br /> ,�uvr uc7 /7T0 rG� tt�w 5�i9C:G �r <br /> C{•��� /4�Y`_ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. 1YPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Dalhtub � Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kilchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clolhes washer _ Clothes dryer <br /> Waler healer Range hood <br /> Sink(service/badmop/elc.) _ Exhaust tan <br /> Oackflow prevenler _ Heal pump <br /> Unnal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floordrain _ Refrigeralion <br /> Grease trap _ Woodstovo <br /> Roo(drains Olher c c�/� <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerility that 1 have read and exami�ed this application and know the same to be irue and correct All provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not.The granling of a permil does nol presume <br /> to give aulhonty to violate or cancel the provision of any other state or local law regulating construction or the periormance of <br /> construclion.That I am aulhonzed b Ihe owner ot Ihis property lo pertorm the work for which applica!ion is made and I comply wilh lhe <br /> State Contraclo 1 2�RCW nd 296.200 WAC. <br /> �,� 3 /7 O 7 <br /> Signalure wn /Contractor/Authonzed Agenl ' DaYe <br />