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F-cRMIT APPLICATIuN <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 ADURESS �� -y�h� PARCEL TAX I.D.p P MIT# <br /> ;� �- s w��s � ��.�s,a-�: ,,,� _ �>�D - <br /> LEGAL LOT NO. � BLOCK TRACT OR SUBDIVISION p <br /> DESC <br /> C NNER AUDRESS CITV2IP PHONE <br /> l;�:C lN(� _ —r— <br /> TENANT NAME CONTACT FOR PERMIT PHONE ,'�� -l/� I"J�l L <br /> ��; - - ��� y(,l�l f��)///�tl�Tl� e-niai�„�kr.{�a�Jnn�al��lo��,i�t. r.� <br /> F,�>Ry p1t K�iNO �oNs7XucTroi�66kF � <br /> c�F�v�u�. �,v( S��A7b�,lv'� �,G•- �UL `Il2•S <br /> CONTR. LICENSEp (f/�',S �(.PI^�;t 5���]H �`,5i ` G <br /> O <br /> _ iI�' MCC i`�C f I{v' _ —_ <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> /i i� L- 5���� �� _Eleclric __Gas__Othcr ��l�� GG C� <br /> WORK DESCRIPTION <br /> ��t,p_;�:�A'lit 1 A,�L Il' jl>���!- SNC r� <br /> PLUMBING MECIiANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toile� NC–air handlinc�units <br /> — D�����i��� Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> -- Shower Water hoa�cr <br /> Kilchen sink 8 disposal _ Gas fireplace ! <br /> Dishwashcr Gas range , <br /> � Clo�hes washer Clothes dryer <br /> Water heater Range hood <br /> � Sink(servicefbar/mople;tc.) _ Exhaust lan <br /> Oackflow prevenler _ Heal pump <br /> Urinal Jnil healer . <br /> Drinking Fc,untain _ Doiler <br /> Floor drain Re(rigeraUon <br /> Greaso trap Woodslove <br /> _ Rool drains __ Olhor I <br /> Olher . _. - . <br /> I =– ----._ ___.— — — .— I <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ' I hereby ceritify thal I have read and examined this application and know tho same lo be Irue and correct. AI�provisions of laws and <br /> i urdinaces 9oveminc�Ihis type o�work will be complied with whether specified herein or nol.The granting ol a permlt does not presume <br /> 'I lo yNe authority lo violate or cancel Um provision of any olher slale or local law regulating r.onstruclion or lhe performance o( <br /> conslruclion.Thal I am aulhorized by the owner of�his property lo pedorm tho work for which applica�ion is made and I comply wilh the <br /> j Stale Conlrar.tors Law td27 RCW and 296.200 WAC. <br /> � � . �I4,i�t.���, ' �!� _ ;I.J,�1N ��r� <br /> Sign� ure of OwnedConlracloriAulhorized P.gont Dato <br /> , �Z <br /> I . .. _ - ------_ _._. .. ... _ . ._-------� � ----�-------�------�--- ----- <br />