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�— ----- — <br /> PERMIT APPLICA►TIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> i 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www•everettwa.org <br /> I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I SITE ADDRESS PARCEL iAX I.D.# P O# '�/ <br /> � a\ S ' <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> OESC. <br /> IOWNER ! ADDRESS CITY/ZIP PHONE <br /> I `Y .�`lcy. C1�.P ��= ee��r ` ��S_�� _ — <br /> TENANT NAME CONTACT F PERMIT ONE )I(LS_�� ..���''�' <br /> ���( `TO <br /> �� �'e \'t'� <br /> l'�.�D.'v\,� e-Ma� <br /> �b-�A�tb� Q �AJD/jDR�S� CNITYe/ZIP � PHONE <br /> CONTR�I�E�\ V� """�'+� �l�7Vl) ` W��SV.� � I��R� d�-10.. (1Q'l'CJ'1�� <br /> ��.��g�a3��.a. �LZ �/� � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric _Gas_Other � � a��'Q� <br /> WORK DESCRIPTION ' �e\„ _ „ <br /> �e(x���c �.si S�cv.c�L,,.c�� ����S��.y o e���:v� �cX� ��,��x <br /> ac�y co�.�.. �n�.S2:�S anc� �a�\s . <br /> - PLUMBING MECHANICAL <br /> NO. NPE OF FIXTU�tE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> il Toilet _ A/C–air handling units <br /> Bathtub Forced air systems <br /> � Lavatory (wash basin) _ Gas piping <br /> Shower _ Waterheater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes wash�r _ Clothes dry..-r <br /> Water heater _ Range hood <br /> Sink (service/barimopletc.) _ Exhaustfan <br /> BackFlow preventer � _ Heat pump I <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> �I Floor drain _ Refrigeretion <br /> I _ Grease trap = Woodstove I <br /> Roof dr2ins Other <br /> "�. Other _ — . <br /> i CIN OF EVERETT LOCAL SALES TAJC CODE IS 3105 _ I <br /> �� I hereby cerilify that I have read and examined this application and know the same to oe true and correcL All provisions ot laws and <br /> ordinaces yoveming this type of work will be compPed with whelher specitied herein or not The aranting of a permit does not presure <br /> to yive authoriCy to violate or cancel the provision o(any other state or local law regulating construction or the performance of <br /> r,onstruction. Thal I am authorizad by the owner of this property to perform ihe work for which applicalion is made and I comply with ihe i <br /> � Slate Conk3�'tofs Liw�827 E�N and 296200 WAC. i <br /> � �( � / <br /> '� � ��`� � � L" ��� �T � V (�� <br /> I S�gnaWreofCkvTeP/(.ontraLtonNuinon �g t Date I�Z �,I <br /> '�� . _. . __ . - -� ------ -- ---- ----_. <br />