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l �. <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 /> � APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PARCEL TAX I.D.# PERMIT# <br /> SITE ADDRESS { l �n •�,7� GL� � � <br /> "L�.�"' `� �� �'� h��l ,'v� ��� ��,Q �(_ � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION S <br /> DESC. <br /> OWNER <br /> ADDRESS CITYIZIP PHONE <br /> �� �.��� ..1 L! C ��'ia� �t.1`�L ��e 1)�.�, ��<n<<t� �f'c��� zIJS-''��..? E�11E- 1 <br /> TENANTNAME � <br /> CONTACT FOR PERMIT PHONE �� �I �� �y� I <br /> �(' r� IU. ��� E•MAIL I'CJ�' /UL1N1�.�i�l C�h <br /> CONTR TOR N�c'�l'� LLL � L'��VEI�'�� 14J2. �✓�V �v�I�+.�CCCI P ���5-L�>� �,y���l <br /> �I���� <br /> CONTR.LICENSE# <br /> USE OF BUILDING <br /> HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleciric �� Gas_Other <br /> WORKDESCRIPTION 1 `� f '�r,,'`` jPS�G�� <br /> �J��J �c„51`�cl�cr� � S� ^� �� y . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM <br /> NO. TYPE OF FIXTURE OR I7EM <br /> A/C–air handling units <br /> i Toilet I Forced air systems <br /> –� Bathtub �� Gas piping <br /> � ! Lavalory(wash basin) � Waler heater <br /> � Shower i Gas fireplace <br /> �[ Kitchen sink&disposal — Gas range <br /> � Dishwasher 1 Clothes dryer <br /> T Clothes washer Range hood <br /> �_ Water heater � Exhausl(an /�/� <br /> Sink(servicelbar/moplelc.) Heal pump <br /> Backflow prevenler Unit healer <br /> Urinal — goiler <br /> Drinking Founlain Refrigeration <br /> Floordrain — y�oodslove <br /> Greasetrap — Other <br /> Roof drains — <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify thal I have read and examined this application and know lhe same to be irue and correct. AII provisions of laws and <br /> ordinances governin3lhis lype of�vork will be complied with whether specified herein or not.The granting of a permit does not presume <br /> lo give authority lo violate or cancel Ihe provision of any other state or local law regulating consWction or the performance of <br /> construction.Thal I am aulhorized by the owner of lhis property lo perform the work for which applicalion is made and I comply wilh the <br /> State Conlractors La�.27 RCW and 296.200 WAC. <br /> , 9/,�/aciU <br /> „�� ���� D le <br /> Signature of OwnP'IContractor/Au�honzed Agen[ ' I� <br />