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�� _b -c� <br /> PERMI'� APPLICATION <br /> CITY OF EVEFtETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810—FAX A25-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> SITE ADURESS ��-Y%�G �{�%�F�Y � L'• � PARCEL TAX I.D.i! PERMIT# <br /> �1C�tT�', Wh tS�Cil GZ-�q=�6(o(o�'L'�x�o , o -US- <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. ZOJ �r�,- u � � et�=�rr ���T <br /> OWNER ADDRESS CITY2IP PHONE <br /> CGLt�Y �Nti13 ��G ?�;'Ll lZtk����AJ� . t���TT �7 -�� • �Itn l <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> G4���n��� c��t�l� ( �t��t i�:�'� q2� - z r�z- 2��i� <br /> CONTRACTOR�j �'�hV !`I�k'T\`�-f(O�,I '4���� cc��Yl�Vb- �1�b'(�TT �ZCJ ' ZG/;�-�i.�11 <br /> V C. l.f�� �` 1 v <br /> CONTR.UCENSE M �'l,L l ��{�pp�;b�= <br /> USE OF BUILDIN HEAT SOURCE C�NTRACT PRICE OF WORK <br /> �xr.aN�,:» ���=..1�Tihl. _ — '��✓ � •�� <br /> Electric _Gas Other � i <br /> WORK DESCRIPTION <br /> ��,i<<�n��a-��ot� � �1xVA�� , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Balhtub Forcetl air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Lau�dry tray _ Range hooa <br /> Sink(service/bar/mop(etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigcration <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OP EVERETT LOCP;. SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and wrrect. All provisions of laws and <br /> ordinaces goveming this type ot work will be complied with whether speci:ied herein or not.The grenting of a permii does not presume <br /> to give authoriry to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> constructioa That I am authorized by the owner o(tnis property to pertortn the work for which application is made and I comply wnh the <br /> Sta ontractors aw 1 27 RCW�pd 296200 WAC. c� <br /> ���� I�i U � "� O�Z�.-�(�i <br /> Sign uiC of Owner/ContractorlAuthonzed Ageni Date <br /> 1� <br />