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� - <br /> , <br /> PERMIT APR'�ICATION <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 PHl <br /> SITE ADDRESS PARCEL TAX I.D.# PER�dlT# <br /> � c �. i v _ Fa�c��-dc6 <br /> LEGAL LOTNO. BLOCK TRACTORSUBDIVISIONp <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> TENANT NAME I CONTACT FOR PERMIT PHONE 3(�O �v SZ�ZS� <br /> (,' 2 c,�r �v � CONSUL 7'/n�y j Lp'��� «7"� E-MAIL <br /> l. NTRAC -� ADnRE —Z fll IP H E <br />� CONTR,LICENSE# <br /> G� �i'�.rn tJ p S Ff 8 3o L� <br /> USE OF BUILUING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> [lectric Gas Other �b� �� _ <br /> WORK DESCRIPTION <br /> A- D D S/N l�- F' 02 e s /Lc.f o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handlinc�units <br /> Bathlub Forr,ed air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler healer <br /> Kilchen sink&disposal Gas firep�2ce <br /> Dishwasher Gas range <br /> Clothes washer _ Clothes dryer <br /> � Waler heater Range hood <br /> ( Sink(service/barlmop/elc.) Exhaust tan <br /> Oackllow preventer Heat pump <br /> Urinal Unit heater <br /> Drinkinc� Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease lrap Woodslove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAI SAIES TAX CODE IS 7105 <br /> I hereby ceritify that I have read and examined lhis application and know the same tn be We and correcL All provisions of laws and <br /> ordinaces governing thi pe of work will 6e complied with whelher speci(ied herein or noL The granting of a permit does not presume <br /> lo give authoriry lo vio al or cancel the provision of any other state or local law regulating conslruction or the performance ot <br /> construc�ion.That I� n dhorized by lhe owner of lhis pronr.rty lo perform Ihe work for whir.h�pplicalion is made and I comply with the <br /> Slale C tractor L � B.2 �CW and 200 WAC. <br /> �2�� �/� � /07 <br /> Sign lure of Owner/Contractor/Aulhonzed Agenl Date <br />