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PERMIT APPLICATION <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 /> i�PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �VO��~�Z3 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> , �r-G✓`.��,� 1.�, o a oo� 1�(�b <br /> LE AL LOT NO. BLO TRACT OR SUBDIVISION# <br /> DESC. <br /> ADQRESS CITYIZIP PHONE <br /> �tb(� S�> �f B / S� ��►'� l� <br /> r�s�����-�� �— ��r 7 �� ����-��� <br /> TENANT N�,ME CONTACT FOR PERMIT PHONE <br /> � � � � �e E-MAIL <br /> �R�/Ge" �r��_ 1 � R �/ z� CIlY21P P O r,`�� <br /> � /v y <br /> CONTR.LICENSE# � <br /> s� r-�� ���'� �t� • /'aco,� r-�-A� S y � <br /> USE OF BUILDING HEAT SO RCE NTRACT PRICE OF WORK <br /> _Electric � Gas_Other �(JG� d � <br /> WORK DESCRIPTION �� �t�G ' 1�% �� S UC�j <br /> � "� _ .C/ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Balhlub Forced air syslems <br /> _ Lavalory(wash basin) Gas piping <br /> Shower Waler healer <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwashor Gas range <br /> Cblhes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(service/bar/mop/etc.) _ Exhausl fan <br /> BackOow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking fountain _ Boiler <br /> Floar drain Refrigeration <br /> Grease trap _ Woodstove <br /> P.00f drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify that I have read and examined lhis application and know the same lo be lrue and correct. All provisions of iaws and <br /> ardinaces governing lhis type of work will be compfc�d wilh whether specified herein or not The granlin�of a permil does not presume <br /> lo give aulhority lo violale or cancel lhe provision nf any other slate or Iocal law regulating conslruction or lhe performance of <br /> construclioq.'ral I a aulhorized by Ihe owner ot t�!s propeRy to perform lhe work for which application is made and I comply wilh the <br /> State C G .�rs 18.27 RCW and 296.200 WAC. <br /> � O <br /> Si e of O,g onlractodAuthonzetl Agent � Dat <br /> �/ <br />