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PERMIT APPLICATII�N <br /> CITY OF EVERETT PERMIT SERVIGES <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 a —Q -�� <br /> SITE ADDRESS �� —2 � PARCEL TAl(I.O.A� PERMIT t <br /> 3�3 W� c�-s, �ro r�� 2 -���ss <br /> LEGA LOT N0. BLOCK TRACT OR SUBUIVISION N <br /> �ESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> 130� I N� <br /> TENANTNAME CONTACTFORPERMIT PHO <br /> ,3��E� N� � L,�r✓�-�-� `��,�-. 7�-z��9� <br /> _�_ e�a� <br /> ��� � � <br /> CONTR.LICENSE N <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��� Eloclric Gas Othar In� eOG <br /> WORK DESCRIPTION <br /> ��I/t-0��'1 �� ���t'/�l�E <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUCTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilel _ A/C—alr handling unils <br /> Balhlub Fotced air syslems <br /> Lavatary(wash basin) _ Gas piping <br /> Shower Walor heater <br /> Kitchon sink 8 disposal Gas flreplace <br /> Dishwasher Gas ran6e <br /> Clolhes washor Clothes dryer <br /> Waler heater Range hood <br /> Sink(service/bar/moplelc.) _ Exhausl(an <br /> Backflow preventer _ Heat pump <br /> Urinal Unil healer <br /> Drinking Fountain Boiler <br /> F�oor drain Re(rigeration <br /> Grease lrap _ Woodslove <br /> Roo(drains Other <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TA7C CODE IS]705 <br /> I hereby ceritify thal I have raad and examined this applicalion and knaw the same to be lrue and correct. All provlsions of laws and <br /> ordlnaces governi�g this lype ol work will bo compliod with wholher spocified hereln or nol.The granting a(a permlt does not presume <br /> lo givo authorily lo violalo or cancel lho provision ot any alhar slale or local law regulaling wnstrucUon or lhe peAormance o( <br /> construction.l I�at I am authorized by lhe ownor ol lhis proporty to pe orm Ihe vrork for which application is made and I wmply wilh the <br /> State ntraclors Law 18' / CW an 296.200 WAC. <br /> /''�rv,�� /1 (! �'✓M�� l, . �i ,�, � <br /> Sl�nalure of OwnedConlractodAuthon[ed Ac�enl Dale ,L' <br /> �---- /` <br />