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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32J0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -�-`'��`17_ <br /> SITE ADDRESS PARCEL TAX I.D.# ,�ERMIT# <br /> �0 Z �V��i�F�EXI Gc� /5707- <br /> LEGAL LOT N0. BLOCK fRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> --� �LO�� � CO �v1 -- <br /> TENANT NAME CONTACT FOR PERMIT PHONE �� _`t7�q__�� Lj <br /> �Gl S �' , /��/�-TIw N G � E-MAIL / <br /> NTR CT R , AD�RESS ���— <br /> C-+�i9Pt/i c 1�i5P.�ti`( s/��' � Acv�N� pF o , ,� ox 3 5 05 �b �- � y <br /> CONTR.LICENSE#/,�� n� AS � i/.O WL iJ-QG�f�i.// W� I�I�� �` �� . <br /> C� � ,� 7 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Elechic _Gas_Other �0' �(/O ! <br /> WORK DESCitIPTION . <br /> %G Z �/S �Ct� C( (,CJ %�c�k ry' � t-c�G�� � � �/ <br /> j u �-n S ' O <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boiler <br /> Fioor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify lhal I have read and examined this applicalion and know the same to be true and correct. All provisions of�aws and <br /> ordin�..es governing this type o(work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to g�ve authority to violate or cancel the provision oi any other slate or local law regulating construction or the performance of <br /> conslruction.That I am authorized by the owner of this proFsrty to perform the work fo which application is made and I comply with the <br /> I State Contra�rs Law 1 7 RCW and 296.200 NAC. � <br /> � 0� /�' � <br /> Signa re of Owner/Co tractod thorized Ayent ate <br /> \� <br />