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•I <br />P(lil:RMIT APPLICANA <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.orgFir <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. t <br />VERMITO <br />v� 3 FEDERAL7S0,?QdQJa&`J <br />7f <br />- LE LOT NO. <br />LOCK <br />TRACT <br />DESC. r/�3 <br />,� T <br />LL' V'4� 11i� ✓ � V <br />OWNER ADDRESS CITYMP .4Lar g70 <br />/nsT ,psi C, /�U.6 ax ssa-Z <br />TENANTNAME <br />I CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITYILIP PHONE <br />t uE.�Eri`%�ICif=iG <br />�a'60ss�� �r,�,eN e010 9�o6 <br />CONTR. LICENSE • 'i96 <br />- <br />- (: V E7P,6 9sro Ds <br />USE <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />�I1�1>'l.fi Y <br />Electric 'N_ Gas _ Other <br />IW — <br />r <br />WORK DESCRIPTION <br />I Ea <br />3G 'Sy s <br />8 PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR REM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />—_ <br />Gag range <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />_ <br />Sink(service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Bolter <br />k _Floor <br />drain <br />Refrigeration <br />{ _ <br />Grease trap <br />Woodstrve <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates 's type of work will be complied with whether specified herein or not The granting of a permit does not presume <br />to give ority to ca el a provision of any other state or local law regulating construction or the performance of <br />con uction. That I' y the owner of this property to perform the work for which application is made and 1 comply with the <br />Ya <br />St a Contractor CW and 296.200 WAC. <br />7a <br />re 0f ner ont for zed Agent Date//� <br />