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— ---- - � <br /> 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 <br /> SITE ADDRESS PARCEL TAX I.D.p PERMIT# <br /> zooZ Ceu, Ave C�CI�Gi1' G��- n��3�o4Zso �zod � /a B� � a/g <br /> LEGA LOT NO. BLOCH TRACT OR SUBDIVISION# <br /> DCSC. 3 � !�� D�p <br /> OWNER ADDR SS CITYIZIP PHONE <br /> PJAox 1236' w�a,�EGaT (r''» Cjkz=,L <br /> �� � - - -- A- 4zs-sai•��- <br /> TENANT NAME CONT CT FOR PERMIT PHONE <br /> f�' I /'� S, � �'vY' _ E-MAIL <br /> �6FT�TOR S —�I I <br /> CONTR.LICENSE# D��Q/tJ <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �[lectric Gas_Other <br /> , <br /> WORK DESCRIPTION <br /> � �-0� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–a�r handling units <br /> Dalhlub �orced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler heater <br /> Kitchen sink 8 disposal Gas firepiace <br /> Disliwasher Gas range <br /> Clothes washer Clolhes dryer <br /> Waler healer Range hood <br /> Sink(service/badmop/etc.) [xhausl fan <br /> Backfiow preventer Heat pump <br /> Urinai Unil heater <br /> Drinking Foun�ain Boiler <br /> Floor drain Refrigeralion <br /> Grease Irap Woodstove <br /> Roaf drains Olher <br /> olher <br /> CIT1'OF EVER[TT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certify hat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances go�eming this typa of work will be complied with whether specified herein or noL The granting of a permit does not presume <br /> ro give autho �y to v' �e or cancei the provision of any olher state or local law regulating conslrudion or the peAormance of <br /> �onslruetfo . �a a rf auihorized by�he owner of this property to perform the work for which appiiwtion is made and I comply with the <br /> h'lale Zontra � r• �18.27 RCW and 29f 200 WAC. <br /> 7-g- la <br /> SignaWre oi OwnedConiractor/Authonzed Agent a�—d e <br />