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- --- -- � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT �ERMIT 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 �O _�-�� <br /> SITE AODRESS � � PARCEL TAX I.D.fJ PERMIT# <br /> ' oo UJ , �-�S�No I �\c�o -o31 <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> ��/��� <br /> TENANT NAME C NTACT FOR PERMIT PHONE <br /> (�UL 'N��• y�,y-� �'7G -2Y9Y <br /> �rs�1 e�a s ki E-MAIL <br /> �-- <br /> , �F,r����L�-^� <br /> j CONTR.LICENS�E N <br /> I <br /> i <br /> USE Of BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �����/ $ H��L l�Y�� _Electric _Gas_Olher ��J�C�/C <br /> WORK DESCRIPTION . <br /> i2��vGpTL � � �d - � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> ! A/C–air handling unils <br /> Toilet -- <br /> Bathtub _ Forced air systems <br /> Lavatory (wash basin) _ Gas piping <br /> Shower _ Waler healer <br /> 'i _ Kitchen sink 8 disposal _ Gas lireplace <br /> � Dishwasher _ Gasrange <br /> � Clothes washer _ Clothes dryer <br /> I Water heater _ Range hood <br /> I� Sink(serviceNarlmop/elc.) _ EzhausUan <br /> '� _ Backllow prevenler _ Hoal pump <br /> Urinal _ Unit hea�er <br /> I _ Drinking FouNain = Boiler <br /> Floor drain Relrigoration <br /> � Grease trap _ Woodstove <br /> , Roof drains _ Olher <br /> � Other---- --_-- — <br /> � — <br /> �� CITY OF EVERETT LOCAL SALES TAX CODE IS]705 <br /> I <br /> �� I hereby ceiitify that I have read and examined lhis application and know the same to be lrue and correcL Ail provlsions ol laws and <br /> � ordinaces yovcrning this typo ol work will be complied wilh whelher spocified herein or noL The grenting ol a permil does nol presume <br /> . to givo aulhority to violale or cancel the provision ol any other slato or local law regulating conslruction or lhe pedormance ot <br /> construdion.That I am aulhorized by lhe owner ol this properly to perlorm the work for which application is made and I comply wilh the <br /> , Sla�e Conlraclors Law 1827/RCW a_qd 296200 WAC. <br /> ��+.,-�..i �'✓��"�-�P iQ/i�3�o <br /> Slgnnture of OwnedConlractodAuthonzed Agen� �a�e � <br /> i <br /> � �� <br />