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� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evere:twa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (�— � S_D�p <br /> SITE ADDRESS PARCEL TAa I.D.# PERMIT# <br /> 2-G/�,w���� F ..-e,,� U �v - <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHO�ZS-7�0—�O7S^ <br /> S�U�.. G���� e y�i2-�/utv� itv� F���� wt�- 9�Zo-� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ��� ��� u,��[)� ADORESS CITYI�P PHONE <br /> `'.� ��,zG-y'K �►.r �J �u�. r,✓r y�zo� Yzf-s.��yYy <br /> CONTR.LICENSE#�LLP�/ � 97ZL�J <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �,5�_ _Eleclric _Gas_Olher � p2 ��JU • v C� <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. 1YPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handlinc�unils <br /> Balhlub Forced air syslems <br /> Lavalory(wash basin) _� Gas piping <br /> Shower Water healer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> �G Waler heater Range hood <br /> _ Sink(service/badmop/etc.) _ Exhaust fan <br /> _ Backflow prevenler Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drain� Olher <br /> I Oiher <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhal i have read and examined this application ar ' ��w the same to be true and correct. All provisions of laws and <br /> ordinaces yoverning this lype of work will be complied with whethei cified herein or nol The granting of a permit does not presume <br /> to give aulhority to violate or cancel the provision o(any other state o, ,ocal law regulating consWciion or the performance of <br /> construction.Thal I am aulhorized by lhe owner of lhis property to peAorm lhe work for which application is made and I comply wilh the <br /> Stale Co kaclors La 18�7 RCW and 296.200 WAC. // /�_ O � <br /> ���� G� <br /> Si�nature o( ner/Conlraclor/Aulhorized Agent Dale <br />