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( � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425•257-8810-FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM!AM TO 4 PM 2 �.�7-O6 <br /> SI ADDRE89 �� • PARCEL TAX I.D./ PERMIT/ <br /> � <br /> LE OT NO. BLOC TIUCT <br /> DESC. � <br /> pyyNEq ADDRESS CITY/LP FM E <br /> �i � � ��'1 � <br /> TENANT NAME CONTACT FOR PF.RMIT P E <br /> �'I ��4 a+'kI�S� I 25 ?�;Z-ZI <br /> �/ l I �"�r ( � "' ' — ` `�II I /� / 1 1r/ %1/ 1I�j PHONE <br /> CONTR.LICENSEt�:`y,/.�/^��� �/� IA/� C,� ��� �//� <br /> �JY�il vT �'' I� <br /> USE OF BUILDINO HEAT SOURCE CONTfUCT PRICE OF WORK <br /> ���?li�� _ElecMc �Gas_Other ���,�/vi W <br /> WORK DESCR�PTION <br /> T��� ��p��� � f� ����i�9 b�,/�,�� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FlXTURE OR ITEM N0. TYPE OF fll(TURE ql ITEM <br /> Toilet AIC—air handling unib <br /> Bathtub Forced elr systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Laundry Vay _ Range hood <br /> Sink(aervice/berlmoplelc.) _ Ezhaustfan <br /> Backflow preventur _ Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain _ 8oiler <br /> Floor drain Rahigeration <br /> Grease trap _ Woodstove <br /> Roo(drains OB�er <br /> Olher <br /> CITY OF EVERETT LOCAL 8ALES TAX CODE IS 7106 <br /> I hereby ceritiy Ihat I have read and ezamined this application nnd know the seme lo be lrue and correcl. All provislons of lawa end <br /> ordinaces goveming this type of work will be complied with whether specified herein or not.The Qrentlng of a permit doas not presume <br /> to give auth to violate or cancel Me provision ol eny other state or local law repulating construdion or the pertormance of <br /> construdi a a euthorized by the owner at lhia property to perform lhe work lor which epplication Is made end I comply with the <br /> State C o 8.27 200 WAC. <br /> (7J <br /> at re o er ontra or Authoriz gent ele <br /> ��L <br />