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rb �� —o <br /> PEr�MIT APPLIC�TIG�J <br /> CITY OF EVERETT PERMIT SERVICES �� <br /> 3200 CEDAR STREET, EVEREl�f, WA 98201 �� 1 <br /> 425-257-8810- FAX 425-257-8857 -�riww.everettwa.or �y{{(y-�'�� <br /> -��-._-� � � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEFSIT& CREDIT CARDS ARE NOT ACCEPTED � <br /> SITE ADDRESS PARCEL TAY:I.D.# /P'E`R�MIT# I <br /> J I � F',J� I C I� � �� �� .�SG U 7CC j0�GGo l--[J�I I G'Cl/.Z- <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> I ��T! � F� �) �� / 3 JS� !�ns/ C�is��i� ,('�� /, v�rc/� �Gh ,S&o'+�b <br /> TENANT AME CONTACT FOR PERMIT PHONE <br /> G<< 1�., ��,�N�r ��� r��9 -�ss�� <br /> CONTRACTOR i3,-�r,- us�l ADORESS � CITY2IP PMONE aG���bfjo� <br /> �`f��l !tc'�Nn^'��n' /Uv'r n/ ;rrl/�r lsf. 95/�. t <br /> coHra.uceHsea ly£�f D�l�°i�l �'J <br /> USE OF BUI t G HEAT SO'1RCE CONTRACT PRICE OF WORK <br /> ���,�,�. Electnc Gas Other J �, d<U <br /> �� — — — <br /> WORK DESCRIPTION - / <br /> li,� .��i.:�ayr� itjP�<'�+ ��7 <br /> P ,I �'� <br /> PLUMBING MECHANICAL <br /> N0. IYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> f �✓ Toilet '� NC–air handling units <br /> Balhtub � Forced air systems <br /> j � Lavatory(wash basin) Gas piping <br /> � Showar � Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> Dishwashor Gasrange <br /> I Clothes washer Clolhes dryer <br /> _ Laundry tray i�J _ Range hood <br /> Sink(servicelbadmop/etc.) _ Exhaust fan <br /> ,, _ Back�ow preventer � ( '� Heat pump <br /> � Unnal Unit heater <br /> �� Drinking Fountain Boiler <br /> ' Floor drein _ Refrigeretion <br /> Grease trap _ Woodstove � �� I <br /> Roof drams Other �� I <br /> _ Other_ _ � <br /> � � <br /> I <br /> CITY OF EYERETT LOCAL SALES TAX CODE IS 7105 � <br /> I hereby ceriti(y that I have read and examined this application and know lhe same to be true and correct. Ali provisions of laws and i <br /> crtlinaces governing this type of work will be complied wilh whether specified herein or not.The granting of a permit does not Dresume � <br /> ;o�ive authonty to violate or cancei the provisian ot any olher state or local law regulating constructlon or the pertormance of � <br /> canstruction. That I am authonzed by the owner of this property to peAorm the work for whioh application is made anC I comp'ry with the <br /> State Cantractore Law 10.27 RCW and 296.200 WAC. <br /> ��' ' `��� 3 � � <br /> �' ' . .(� �fL:'7t-fc � '� <br /> �gnacure u wnenContracronAul nzod Agent ate i <br /> � <br />