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i <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT'_ADDRESS PARCEL TAX I.D.# PERMIT# <br /> `�70� C�,�t�irl[c�C� F��; C7C�i? ,.G��y�r�i�n', /.�tUCDd 1-06��1 I <br /> LEGAL LOTNO. BLOCK TRACT i <br /> oEs�. Eterc�f - !/S O�o D-c>' � !Z <br /> OWNER AODRESS CITY/ZIP PHONE I <br /> `� '� L(���'aC}�-':/j��/ <br /> ,�r-1v„� '1=. 1�-.�nlefd iz�,�+J ��70�� C,Ic.r�com �ve- L�;eiE-� �87�3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE � <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE X <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �� � � Eleclnc XGas�her <br /> �rtiE,lc Fi�r�rC.� =� <br /> WORK DESCRIPTION �i�,���t�, ��y� ��rn� f/e�'7� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. NPE 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&disposal _ Gas 6replace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/barlmop/etc.) _ Exhaust fan <br /> BackBow preventer _ Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refngeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby centify that I have read and examined this application and know the same to be true and corted. All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> tagive authoriry to violate or cancel the provision of any other state or local�aw regulating consWGion or the perfortnance of <br /> � nstruction.That I am authorized by the owner of this property to perform the work for which application is made and I compiy with the <br /> � St te Contracto s Law-�B 27 RCW and 296200 WAC. <br /> � <br /> J' � , i T � b(�, <br /> , . <br /> ig aWr edContr to u on ed Agen ate <br />