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PERMIT APPLICATiON I�� j� <br /> CITY OF EVERETT PERMIT SERVICES �I <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> l�' 7 APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PER T# <br /> '�� �V�RGRLEN war �- �020000c� i oo , �;-�� <br /> LEGA L0T N0. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER 6O� Of�11S � �LI�CISZFA��LPHWA ��Og <br /> I�/�tJcR CHf�.lg�� A�i^. <br /> TENANTNAME �fj�� y�R�F{ CONTACTFOR PERMIT PHONE sf'Z,C) t�.C� Oj�(p <br /> �UpAP$F�h! QUALiT�r M�a-s I Ro� N�,�.Y AIA E•MAIL rX+�CH�,rau. �ce <br /> ��/ ��' ADD I I <br /> CON iR.LICENSE# S /�'"n'�'� G,I �"_ " � ��� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> R�A��._. _Electric _Gas_Other � ��-- <br /> WORKDESCRIPTION ��� wA,L� II`� �IJ�ING 11AIZI�E-T <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet AIC—airhandlingunits <br /> _ Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler healer <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Cbthes dryer <br /> _ Waler healer Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> _ Backllow preventer Heal pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> _ Floordrain Refrigera�ion <br /> Grease lrap Woodstove '� <br /> Roof drains Other <br /> Olher <br /> CITY OF EVERET�LOCAL SALES TAX CODE IS 3705 <br /> i hereby certify lhat I have read and examined this application and know the same to be t�ue and correct. All provisions of laws and <br /> ordinances governing this type of work will be complied wilh whether specified herein or not.The granting of a permit does nol presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> constru tio ('fT�a I m au rized by lhe owner of ihis property to perform the work for which application is made and I comply with the <br /> Sta on �ctols 1 .27 RCW and 296.200 WAC. <br /> � � <br /> i n ture of wn rac r/Aut nzed Agent Oale � / <br /> Iz <br />