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. � <br /> ; <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, bJA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# Z.90ra��00?DBI� PER IT# <br /> IZpS G1�fs�T�6•J�/k�l WhY 24oS1'b�?�610�� 24oS1�le '� - j� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> 'C'oK-T � �VE12E1�" IPo• �iC s38 �V�R�t'� �18?1�(0 <br /> TENANTNAME CONTACTFORPERMIT PHONEAZ�'Z��L'ZIS?J <br /> �.u'tTl.�#�rlT'�REW W!�G�� I 2�t Z hP�FI�Ttt c2� —r �"�"' <br /> �/�.�(�,� E•MAILid?w1Q2b121YG�11�su�y �,.� <br /> NTRA T R AD �(T.I� 1 H <br /> C�/F�N��C C�(JS7VL-Lt�Tlohl Sln� 'f3R�`KAY �VF�k—lT �3ss� <br /> CONTR.LICENSE A ����LT lO� 1�2 Q Q.�^� <br /> y F�7 �Zli' <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> 00 <br /> �—�i _E�ectric �Gas_Other '� 0O���0 <br /> WORK DESCRIPTION <br /> � E�v �T,�+,r�.►-�" lfi�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toiiet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireptace <br /> Dishwasher Gasrange <br /> Clothes washer Ctothes dryer <br /> Water heater Range hood <br /> Sink(servicelbar/mop/etc.) Exhaust fan <br /> Backilow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Giease lrap Woodstove <br /> Roof drains Other <br /> i Other <br /> CIN OF EVERETT LOCAL SALES 7AX CODE IS J105 <br /> I hereby certi(y that I have read and examineC this application and know the same lo be Irue and correcl AU provisions of laws and <br />� ordinances goveming this lype o(work will be complied with whether specified herein or noL The granting of a permil does not presume <br />� to give authonty lo viotate or cancel the rovision of any other state or local law regula6ng consWclion or the perfortnance of <br />� c�nstmclion. T t I am authori d b owner of lhis property to pedorm the work(or which application is made and I comply with the <br /> State Contra rs t aw 1 27 W nd 96. 0 WAC. <br /> •Jn• O <br /> Signa u of OwneUContractodAu onzed Agent Date (' <br /> � <br /> I — —— — <br />� , <br />