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-14-D <br /> PtRMIT APPLICATIUN <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 PAkCEL TAX I.D.k FERMIT N <br /> , ,�- .L, �i�w3 � ^ o � olv ' 0..3_3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AUDRESS CITY2IP PMONE <br /> L J-�� � J <br /> TENAN'f NAME CONTACT FOR PERMIT PHONE <br /> �� ��n�� ��E J G1S��/l�--_ <br /> CONTRACTOR Af+DRESS CINIZIP PHONE <br /> CONTR.LICENSE p �/�0�� �� <br /> USE OF BUILDIyG• _ I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> �' / i� <br /> e-�fw/ Electric _Gas Olhor <br /> WORK DESCRIPTION / <br /> /� ,�d M l S�i F �,�Lt.} p,•vcc`u � c.� � � � <br /> /-'-� � 7�` '� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilol .NC–alr handling units <br /> Bathtub forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Walor hoater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwashor Gasrango <br /> Clothes washcr _ Cl�thes dryer <br /> Watvr hoator Range hood <br /> Sink(sorvico/bar/mop�elc.) _ Exhausf(an <br /> Backllow preventer __ Hoal pump <br /> Urinal Unil h�ator <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Rofrigeration <br /> Grease trap _ Woodstove <br /> — Roof drains — I = Olher <br /> Othar — <br /> CIiY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I horeby cerilify that I have read and ezamined this application and know Ihe samo to bo true and correcl. Ail provisions of laws and <br /> ordinaces governing this lype of work will bo complied with whelher speci(iod herain or not.Thn granting of a permit does not presume <br /> to givc aulhority lo violato or canccl thc provision of any oihcr slate or local law rogulating construction or lhe peAormance ot <br /> conslruclion. That I am authorized by lhe owner of Ihis properly lo pertorm Ihe work tor which applicalion is made and I comply wilh the <br /> Slalo Coniraclors Law 1827 RCW and 29fi.200 WAC. <br /> Signature ol OwnedContracbdAuthorized Agent Dato <br />