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-- ---I <br /> P�:RlVIIT Q.PPLI�ATIVN <br /> CIT't OF� EVERETi' PERMlT SEh"VICES <br /> 320G CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FftOM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# �P MIT# <br /> 5��� � � - ' �L t / _��� <br /> LEGAL LOT NO. � BLO TRA�' <br /> DESC. <br /> OWNER AO�RESS CITY2IP PHONE <br /> TENANT NAME I CONTACT FOR PERMIT PHON6 <br /> '�p,�,� Cc (�- �'�v I �Gt�-�� ��CJt�I./�/n,t� //�/C , <br /> CONTRACTOR �,��5 pL�mR/�� I/1K' DDSS3O'jZ/QU- S' SIt?«�i%GtVC�itJ�J�Z7/'�'/S� <br /> ! <br /> CONTR.LICENSE# �iIN� p��' y/ J/� ��J Ny- <br /> /" / ;�� �T r <br /> USE OF BUII_DING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �J� � �� , Eleclric Gas Olher <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> alhlub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower � Waterheater <br /> Kitchen sinh 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Cbthes dryer <br /> Water heater Range hood <br /> Sink(service/badmop/etc.) Exhaust tan <br /> Backflow preventer Y Heat pump <br /> Urinal Unit heater <br /> Drin�inq Fountain Boiler <br /> F�oor drain Refrigeration <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Cther <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhal I have read and examined lhis application and know lhe same lo be true and correct. All provisions of laws and <br /> ordinaces governing this lype of work will be complied wilh whether specified herein or nol.The granting of a permit d�es nol presume <br /> �o give authority to violate or cancel Ihe provision of any other s;ate or local law regulating consWclion or the performance of <br /> conslruction.That I am authorized by lhe owner of this property to pertorm lhe work for which application is made and I comply with the <br /> State Coniractors Law 18.27 RC and 29G.20 WAC. <br /> � ������� <br /> Sic�na of 0�/ o r o A honz genl Date <br />