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� - <br /> �CkMIT APPLICATIUIv <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425�257-8810- FAX 425-7.57-8857�-www.everettwa.org l D ��u �Q,(j <br /> � I�� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS ;- PARCEL TAX I.D. p PERMIT I! // <br /> , .: � l` �l,Ls / n c� , 'i7��� � �/k� <br /> LEGAL LOTNO. BLOCK TRACT <br /> �ESC. <br /> OWNER ADORESS � CITYIZIP PHONE li2�_�2_ 5� � <br /> .3 & F3 ?NvEs7MeNrs 2j �S, � �6 S-t IJE TU�qu/� qgz�� 4zf-232-is r <br /> TENANTNAME CONTACTFOR PERMIT PHONE <br /> BALBIR SiNG,N L1ZS -232- ISS f <br /> CONTRACTOR AUORESS CITY2IP PHONE <br /> CONTR.LICENSE p �� C�W/•..�f_� — <br /> USE OF BUILDING T I NEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleclric Gas Olher <br /> WORK DESCRIPTION <br /> /T:1-c.t��{� /�'^^ /i ,� �r,�� � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE UR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–alr handling unils <br /> Balhtub Forced air syslems <br /> Lavalory(wash Uasin) _ Gas pipinfl <br /> Shower Waler healer <br /> Kitchen sink 8 disposal Gas(ireplace <br /> Dishwaslier Gas range <br /> Clolhes washor Ciothes dryer <br /> Walor heater Range hood <br /> Sink(Service/bar/mopletc.) _ Exhaust fan <br /> Backflow preventor _ Hoat pump <br /> Urinal Unil heator <br /> Drinking Fountain _ Boiler <br /> Ftoor drain Reldgeration <br /> �reaso Irap _ Woodslove <br /> Rool drains Other <br /> Olhcr <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby coritity�hal I have read anA examined ihis applicalion and know Ihe same lo be lme and correcl. AI�provlsions of laws and <br /> ordinaces govornine�lhis lype ol work will be cornplied wilh whelher specified heroin or not.The granting of a permit does not prnsume <br /> to give authorily to violato or cancel ihe provision of any other stata or local law regulating construction or lhe performance ol <br /> construction.That I am aulhorizod by Iho owner of Ihis proparty to peAorm lhe wnrk lor which application is made and I comply with lhe <br /> Slato Coniractors Law 18.27 RCW and 296.200 WAC <br /> `�'�1 . Ibl�3 �� <br /> Siynabre of OwnodContractodAulhorized Ayenl ate <br /> � ----._. _.. _- - <br />