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—� � <br /> PERMIT APPLICATION �0 f� <br /> CITY OF EVERETT PERMIT SERVICE U— � nj <br /> 3200 CEDAR STREET, EVEREI7, WA 98201 p,�a <br /> 425-257-8810—FAX 425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� (�p� - p07 <br /> SITE ADDRESS PARCEL TAX I.D.# ��v� S� <br /> ro�o+iE�wM'iWi� 9e¢or f.Ze42fan-o3ico <br /> LEGA LOT NO. BLOCK TRACT � <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> .�os¢pft �4�� !O(o33aQ162G.�1J�nA'�f E✓�;4'IT'`1w+ <br /> T��Nq�k C�OtN�T�AC�FOR PE MIT PHONE <br /> /�4 <br /> "��I�ptSH's�LL /�{J.�I/7�' S 4'�' �i5q'O�ob <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE M <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��—�� �n� I _Eledric �,.,Gas_Othei ��?{ 0�{0'"� <br /> I <br /> WORK DESCRIPTION <br /> 3'!3►'1-� Q�LIC.1c.Ltt�,E CA.'t�ltt'�C QuILTOF GNIl f3tarL d�f51¢.�►GTlbN <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ AJC—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower� Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> _ Dishwasher'� _ asrange <br /> _ Clolhes washer�� _ C hes dryer <br /> Laundry tray _ Ran hood <br /> Sink(service/bar/mo elc.) _ Er.haus an <br /> Backflow prevenler _ Heat pum <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> � Floor drain _ Refrigeration <br /> Grease trap Woodslove <br /> � Roo(drains � Other�IMlT <br /> ,� Other�a1.O W k(�2 _ . <br /> CITY OF EVERE OCAL SALES TAX CODE IS 3105 � <br /> I hereby ceritity that I have read and examined this application and know the same to be true and coRed. All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein ar not.The granting of a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other state or local lew regulating construdion or the periormance oi <br /> construction.Thal I am authorized by the owner of this property to periorm the work for which applicalion is made and I comply wdh the <br /> Slale lr o�ta 18.27 RCW and 296.200 WAC. <br /> [) 4• ZI-tpc(o <br /> Sig�f ature of OwnedConlradodAuthorized Agent Date �^ ���� �/2 <br /> l"� <br />