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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 B AM TO 4 PM 1 ...0�-D d <br /> SI?E ADDRESS >' f� �"- �`'� � «� PARCEL TAX I.D.p PER�IT N <br /> ���n3 �nl, (? � ;,� -, � i�;� . I .���'C�7- ��� <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> �%�Fi"�� <br /> TENANT NAME ONTACT FOR PERMIT P ONE � <br /> yq�,/� t � �� <br /> l/� v�l'��' '�i'�(��/�����f,�' �, i ��C•J EMAIL�C-.� � <br /> �"6AT�F7C -ADb�€SS 1 <br /> ( 4 �� /!�1 E 1i.�1�i,✓�, < <��'_,%. <br /> C�NTR.LICENSE N <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �/f _, �, �� �_-�.CT-f O/./ � _Eloc�ric _Gas__Other � /�� p D :7 <br /> WORK DESCRIPTION <br /> .� , � - ,� ;�c'/(.�/�-�, Sl�._U <br /> ��{ � r /,' /'. j; t , �',� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> Toilcl __ A/C-air handling units <br /> BathWb _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kilchen sink 8 disposal _ Gas tiroplaco <br /> Dishwasher _ Gas range <br /> Cbthes washer _ Clolhes dryer <br /> Waler heater _ Rango hood <br /> Sink(sorvice/bar/mopletc.) _ Exhausl fan <br /> � Bsckllow prevenlcr _ Heat pump <br /> Urinal _ Unit healer <br /> Drinkinc�Fountain _ Boiler <br /> Floor drain _ Refrigeralion <br /> Greaso Irap _ Woodstove <br /> Roo1 drains __ Olhar <br /> Olher __ — <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 7705 <br /> I hereby coritily Ihal I have read and examined this application and know Ihe samo to be Irue and correct. All provisions of laws and <br /> ordinacos gov�ming Ihis type o�work will be complied wilh wholher specilied horein or noL Tho gran�ing o�a permit does no�presume <br /> to yive aulhorily to violate or cancel Ihe provision of any olher s�ate or local law re9ulaling consiruclion or ihe pedormance of <br /> conslruction. Thal I am authorized by the owner o�this prop�rty lo perlor i Iho work lor which applicalion is mada and I mmply wilh�he <br /> Slat CoNractors Law 1&'�RCW a�d 29G.200 WAC. �� <br /> 7 , <br /> ,,�,,�^,l � ��,t„<A l, � �—`9 �' c`� <br /> Si9naWreolOw dCoNraclodAuthorizedA�ent Dale � � <br /> �� <br />