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� <br /> PL.IMIT APPLICATIG.� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT N <br /> aa3c� — � o�o� -o�_ <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER v� �U� 5u ADDRESS CITY2IP PHONE <br /> ` I �io9— l1�2.lue2c.�n.�Ld A16' <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CON ACTOR ADDRESS CITY2IP PHONE <br /> �o��s���yl3��v� �Eo��o6r�,a��i � ����n �os -aa�7s�7i <br /> io�A� P�`oQ4v,� q���� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electnc Gas Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF fIXTURE OR IiEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A1C—alr handling unils <br /> Bathtub Forced air syslams <br /> � Lavatory(wash basin) �� Gas piping <br /> Shower Water heater <br /> � Kitchen sink&disposal Gas Hreplace <br /> � Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray /�r — 9 <br /> _L Sink(servic /bar/m�) Exha stfan <br /> i � Backflow prevenler Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Founlain Boller <br /> Floor drain Refrigeration <br /> � Grease trep Woodstove <br /> Roof drains Other <br /> � Other !nilJ�hec1 �,UdiNs '— <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this appllcafion and know the same to be We and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specifiea herein or not.The granting of a pormit does not presume <br /> to give authonty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.Th I am authorized by lhe owner of this property to perform the work for which application is made and I comply wilh the <br /> Stale Conlraclo aw'8.2 RCW and 296.200 WAC. <br /> ��J <br /> Signaturo of nedContractodAuthonzed Agent Dat� <br />