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F��RMIT APPLICATI�N <br /> CITY OF EVERFTT 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 E �1(�- 0� <br /> SITE ADDRESS --rI1 ' '`� - PARCEL TAX I.D. # PERMIT# 7 �/ <br /> 'r-k9f (r.� , (' ��,� �,��;; .: i) �' �-� / <br /> IEGAL LOT NO. BLOCK TRACT OR SUB�IVISION p <br /> oesc. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> <,�+�C; r�J �- <br /> TENANT NAME CONTACT fOR PERMIT PHON ,/ <br /> 1,' ' �Z-�-� ���' �'> >'� <br /> r„��� r ��• j�j�r���, �?��.s� � E.�A�� � <br /> —�� - <br /> ���"—y �'7E2L1,,;�, (��i�� j"j. <br /> CONTR.LICENSE M <br /> USE OF BUILDING IIEA7'SOURCE I CONTRACT PRICE OF WORK <br /> �/,� (..V�� (7r �:i � �., _Eleclric _Gas_Other �7��j (� �(� <br /> I <br />� WORK DESCRIPTION <br /> (��71r� •�—n-c'-` f /lF- �-� CF-�s �•/ �:I�iS'_r!;'�— <br /> PLUMBING MECHANICAL <br /> N0. TlPE OF FIXTURE OR ITEM NO. TYPE OF FUCTURE OR ITEM <br /> Toilel A/C—air handling unils <br /> BathWb Fo�ced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Showcr Water heater <br /> Kilchon sink 8 disposal Gas lireplace <br /> Dishwasher Gasrange <br /> Cbthes washr.r Clothes dryer <br /> Water heater Range hood <br /> Sink (servicc/badmoplolc.) Exhausl fan <br /> Dackflow preventer Heat pump <br /> Urinal Unil heatar <br /> Drinkinp Founlain Boilor <br /> Floor drain Relrlgeration <br /> Groaso Irap Woodstove <br /> Roof drains Olher <br /> Olher <br /> GTY OF EVERETT LOCAL SALES TAX CODE iS 7105 <br /> I horoby cerili(y that I have read and examined this applir.ation and know the same to be true and correcl. All provisions ot laws and <br /> o:dinaces govemin�Ihis typo of work will bo complied wilh whelher speciliod herein or no�.The granting o(a permil does nol presume <br /> lo give aulhorily to violalo or r,ancel Iho provision ol any other stato or local law regulalinc�wnstruclion or the performance of <br /> conslrur,tion. That I am�uthorized t�y tho owner o(this proporty to ppAorm Qio work lor which applicalion is made and I comply wilh the <br /> StatgConlrar.lors La�y-18127 RCW�Ond 29G.?OO WAC. <br /> / • i 7 / <br /> �"^^-,, .-� / l..e'^" I� � ..I ,� <br /> �, � . <br /> i�nalure ot OwnedContractor/AuthorizeA Ac�ent Dale <br /> �/ <br /> L <br />