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� -- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-6810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / 2 —���� ; <br /> SITE ADDRESS PARCEL TAX I.D.# PER 7 N <br /> , 10/Z- <br /> ,-�., it �. � I �-� � , i�� ,.'c <br /> LEGA l0T NO. �' BLOCK TRACT OR SUBOIVISION p <br /> D[SC. <br /> OWNER ADDRESS CITYRIP PHONE <br /> TENANT NAME . I CONTACT FOR PERMIT PHONE •�-{ �L!- "�q ( - yy'7 S <br /> 1-�i��� 4 �.('-jj - <br /> Z`�NTkA�`���x>{-'-� 1^-�t y' a� C � I � l e b$ 2� -y�TfP7 EMAIL <br /> CONTR.LICENSE# � <br /> � �`''.'.''--'—.`.�.--� '1-i_._�_ �'�L..--�-�--`l'L`"__`C <br /> USE OF BUILDING HEAT SO CE CONTRACT PRICE OF WORK <br /> �, � � _Electric _Gas_Other <br /> WORK DESCRIPTION _ <br /> If�� : r`_-�-.�.L,--.� 1-c....� C�cC.�_+�`„s-....._----�. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIX7URE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler healer <br /> Kilchen sink�disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater _ Range hood <br /> Sink (service/bar/mop/etc.) Exhaus�fan <br /> �ackflow prevenler Heal pump <br /> Unnal Unil heater <br /> Drinking Founlain Boiler <br /> Floor drain Re(ngeration <br /> Grease trap Woodstove <br /> Roo(drains Uther <br /> Olher <br /> _I <br /> CIN OF EVERETT LOCAL SALES TAx CODE IS J705 <br /> I hereby ceiiify Ihat I have read and examined this application and know lhe same to be lrue and correct. All provisions of laws and <br /> ordinances governinc�this type of work will be complied with whether specified herein or noL The grenting of a permil does not presume <br /> to glve authority to violate or cancel the provision of any other stale or local law regulaling wnslruction or the pertormance of <br /> construdion.Thal 1 am authorized by the owner of Ihis property to perionn ihe work for which application is made and I compiy with the <br /> State Contractors Law it327 RCW and 29G.200 WAC. , <br /> : , - —----.�r i. �-----\�,- � � �rl- � '1 l �.— �"� j /[! <br /> ]�— <br /> Signatura oi OTvnedContractor/Aul orired Agent Date <br /> J�z <br />