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PERMIT APPLICATION <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 r'�'i' °'� PARCEL TAX I.D.# PERMIT p <br /> .,�,�•� [�, C �s /�/o �'-v. l� �1.�/� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> OESC. <br /> OWNER AOORESS CITYIZIP PHONE <br /> G�_ �r�c., <br /> TENANT NAME C9�TACT FOR PERMI? PHON <br /> /�r - ��o/' r (`I'����%l -�.�-9y <br /> Eo� : �i�=- � �� � � � _,�i E•MA <br /> , <br /> J�,Gn-c,i rd,� Gnu�7./ y I �.S l�� P+Va � �s�,o7n,E a�in�' ��nE) 7l••� -9/'�-f' <br /> CONTR.LICENSE k <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> `�' �^ �_n <br /> ��I. �y5 i� I) F'.i"�_ C�Crt�(L- _E�ecidc _Gas_Olhoi L.���� <br /> WORK DESCRIPTIO�I <br /> �l�'%/� Ll� /�'I (__!/� L CL/�'ST ��-��/t.0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling unils <br /> �athtub _ Forced dir systems <br /> Lav��ory(wash basin) __ G:�s piping <br /> Shower Wa�ttr healcr <br /> Kitchen sink 8 disposal Gas(ireplaco <br /> Dishwash^r Gas range <br /> Clolhes wa•,her ("olhes dryer <br /> Wator heal��r Range hood <br /> Sink(scrvice,�badmoplei�.� _ Exhausl(an <br /> Backflow prevenler _ Heal pump <br /> Urinal Unit heater <br /> Drinking F��.mlain _ Boile� <br /> Floor drain _ Refrigera�ion <br /> Greaso�rap V/oodsfove <br /> � Roo1 drains Othor __ <br /> Other _ <br /> ICIT1'OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilily lhal I have read anA examineA this application and know the same to be lruo and corracL All provisions ot laws and <br /> ordlnaces governiny�his�ype of work will be complied with whother spoci(ied herein or nol The granling of a permi�does not presume <br /> to give authority to violatr.or cancel the provision ol any other slale or local law re�ulating conslruction or Ihe peAormance ol <br /> consiruclion.Thal I am aulhorized by lhe owner ol thia propoAy�o peAorm lhe work for which applicalion is made and 1 comply with lhe <br /> Stal�Conbactors Law 8 7 RCW nd 29G200 WAC. <br /> � .�l°j"�cr^���• ����3 ��� <br /> ,.,-.- <br /> Ignalure o(Ownorl�.onlreclor/Au�horized Agent Dale �i <br /> � <br /> � `� <br />