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� PE�RMIT 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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDR S PARCEL TAX I.D.# P RMIT# <br /> � C%E7 Cc c%L: J G'O c� po� O O � ��� - Cl � <br /> LEGAL LOT NO. LOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> � �� � � <br /> � � i <br /> TENAN NAME /CONTACT FOR ERMIT PHONE <br /> �/�� Cil < '� /�'�' / � 5�3 " � I c� I <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE� , j� �/� CONTRACT PRICE OF WORK <br /> J� .c i lJ/l.(� <br /> � � ,[/ _Electric _Gas�Olher \ � 3 S(U <br /> /\ <br /> TT / <br /> WORK DESCRIPTION `/ <br /> �j �� � �� (,C�J �-�� �2'L 1`GU`e �°.c� /l O�i S � � <br /> � ����C , <br /> MECHANICAL <br /> PLUMBING <br /> Np, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Balhlub _ Forced air syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireolace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clolhes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/bar/mop/etcJ _ Exhausl fan <br /> Backflow prevenler _ Heal pump <br /> Urinal _ Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain _ Refrigeralion <br /> Grease trap _ Woodstove <br /> Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this type of work�vill be complied with whether specified herein or not.l he granting of a permit does not presume <br /> to give authority to violate or cancel the provision o(any other state or local law regulatin�ccnstruction or the performance of <br /> constru.:tion.That I am aU�horized by the owner of this property to perfortn lhe work tor which application is made and I comply with the <br /> St�te G/ntrac rs La 8�2�RCW and 29 ._ � /O /� <br /> �SI re � � vn � c or Au honzed Agent � Date � � <br /> �� <br />