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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRnM 8 AM TO 4 PM `�� ��08 <br /> SRE ADDRESS � PARCEL TAX I.D.p PEHMIT 1! <br /> c. � Oo`(O��GO oL �� � oS-al�l <br /> L-GA LOT NO. BLOqC TRACT OR SUBDIVISION p <br /> DESC. <br /> O NER ( AUDRESS CfTYIZIP PHONE <br /> S�er� I �fc�.�..��-k `� 1 I Z Cor�w�er�i�,.Q �,c1�/�� � Z��L' z�`��51 <br /> TENANTN E CONTACTFOHPERMR PMONE <br /> E�MINL <br /> CONTR.IJCENSE if v w �� S <br /> USE OF BIJILDING — HEAT SOURCE CONTRACT PRICE OF WORK <br /> In/J�,{L Eleclri Gas_Olher � �d � <br /> WORK OESCRIPTION <br /> �-t'-" q�:s ,� �� ,^� 3 � P�' �'G,� c..e�. <br /> MLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEid NO. TYPE OF Fl[NRE OR REM <br /> Toilet NC–a?r handling units <br /> Bathtub Forced air systems <br /> _ Lavatory(wash basin) � Gas piping <br /> Shower Waler heater <br /> _ Kilchen sink 8 disposal Gas lireplace <br /> Di;hwasher Gas range <br /> Clothes washer Clo�hes dryer <br /> Water heater Range hood <br /> � _ Sink(service/bar/mop/etc.) _ Exhaust la� <br /> BackOow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floordrain _ Refrigeration <br /> Grease trap Woodstove <br /> Roof drains ther <br /> Other � � � <br /> � ,-� CfTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � -- <br /> i <br /> I hereby ceritity t �t I have read and examined this application and know lhe same to be true and correct. AII provisions of laws and <br /> ordinacas gov ing ihfs type of work will be complied with whether specilied herein or not.The granting ol a perrnit does not presume <br /> to give autho y,to violate or ncel the provision of any other state or tocal law regulating construction ar the perlormance of <br /> constructio at I am auth ed by the owner ol this property lo perlorm t e work for which application is made and I comply�Mlh the <br /> Stale Co r tors Law 18. RCW and 296200 WAC. � <br /> 'G--,. o (� <br /> Signa ur iOwne o ractor/Authorized Agent ate <br />