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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 S --�--0� <br /> SI7E ADDRESS PARCEL TAX I.D.# PERMIT p <br /> ?5�'-I ��F � ,. ' .�.:rl Cc�r% « �jC)SSOj-�Z <br /> LEGAI LOT N0. BLOCK TRACT OR SUBDIVISION M <br /> DE� <br /> OWNER ADDRESS CITY2IP PNONE <br /> ( .. � i 7 yfr zs- /uZ� h .51 S F /�I ..e l*J/I `JZ� Z5'c 20�8 <br /> _tL/'�i.✓in [<.Y•,:� / �� <br /> TENANT NAME� � CONTACT FOR PERMIT PHONE <br /> I E•MAII. <br /> �6ATIFA'L`Tbli— --Abb�€§S � <br /> CONiR.LIC[NSE N � ,� <br /> ( � U/��'1 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Elec�ric Gas Olher <br /> WORK DESCRIPTION <br /> ( � <br /> C L� �Z�'� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FII(TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tailcl A�C--air handling unils <br /> Delhlub Forced air syslems <br /> Lavalory(wash basin) Gas piping <br /> Shower Walor heater <br /> Kitchen sink 8 disposal _ Gas lireplace <br />� Dishwashcr Gas range <br /> Clolhes washer Cb�hes dryer <br /> Water healer Range hood <br /> Sink(sorvice/badmop/etc.) _ Exhausl tan <br /> Backllow preventer __ Heat pump <br /> Urinal Unit lieatcx <br /> Drinking Fountain _ Boiler <br /> Floor drain Relrigeralion <br /> Grcaso trap _ Woodstove <br /> Rool drains Other <br /> Other _ <br /> CITY OF EVFRETT LOCAL SALES TA%CODE IS 7705 <br /> I hereby corilify ihat I havo read and oxamined this application and know ihe same to be true and corrocl. All provisions of laws and <br /> ordinaces c�overning ihis lype of worti will be compGed witli whether specilied herein or nol The granting of a permit doos nol presume <br />� lo y'ro aulhorily to violale or cancel Ihe provision ol any uther slato or Iccal law regulating corsWetion or lho pedormance o� <br /> constructlon. That I am aulhorized 6y ihe oNner ol Ihis pnperty to pedoim ihe work for which application is made and I comply wilh Ihe <br /> Slale Conlraclors Law 1B.27 RCW �inA 29u 200 WAC. <br /> - _ S/Z/� <br /> Si naturc of wno ontracbdAuthoriz�d A9ent Dato <br /> � - -- --- --- ----- ---� <br />