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P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.urg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � t" � ,� j , (�� <br /> SITE ADDRESS � PARCEL TAX I.D.# PERMIT il <br /> �L�-1G SINb� <br /> LEGAL LOT NO. BLOCH TRACT OR SUBDIVISION p <br /> DESC. <br /> OW ER ADDRESS CITYIZIP PI10NE <br /> , � z3r�z-�,��aa� s 1(etirc�A9�a�l <br /> TENANTN E CONTACTFORPERMIT PHONE <br /> E�hIAIL <br /> CONTR.LICENSE p L.M1C� / v' �—l/ <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric V Gas__Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TUFF OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 7op.,� AIC—air handling unils <br /> Dalhtub Forced air syslems <br /> Lavalory(wash basin) � Gas piping <br /> Shnwer �_ Waterhealor <br /> Kilchen sinV. 8 disposa! � Gas fireplaco <br /> Dishwasher _ Gasr2n�o <br /> Clothes washer Clothes dryer <br /> _ 1,Vater heater � Rango hood <br /> _ Sink(scrvico/barin:�p/cic.) I Ezhausl fan <br /> Backflow provonter Heal pump <br /> Urinal Unit heator <br /> Drinking Founlain _ Boiler <br /> Fluor draln Rofrigeralion <br /> Grease irap Woodslove <br /> Rool drains Clher <br /> Olhor _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I howby coriti(y Ihat 1 havo read and examined this application and know lho samo to be truo and correct. All provisions of laws and <br /> ordinaces c�overning this lvpo of work will bu complieA wilh whelher spoci(iad herein or nol.Tho granting ot a permit does nof presume <br /> to�ive aulhoriry Ie violato or cancel tl o provision ol any othar state or local law regulating conslruction or the periormance of <br /> construclion. That I am aulhorized by iA ownor ol this proporly to per(onn lhe work for which applicetion is made and I comply wllh Ihe <br /> S�ate Coniraclors Law iB.27 RCW nn 9fi.200 WAC. <br /> c� b o� <br /> Signaluro of OwnmlCorir odAulhMi d qont a <br />