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P�RMIT APPLICATI(.,N <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 ADDRESS PARCEL TAX I.D.# P MIT# <br /> zo i LU� ��+�- ,�u� aU �3 �� Sz�s- s.� <br /> oesc. k� b7 T I 3 I y I.r e�ocK TRAY-'�IA �' �iJ'�o- �-V�' �i (JO y <br /> v <br /> OWNER � �S rU1^ � ^ f �5 _ CITY2IP PHONE ( I <br /> yy� ,�k a� I �,- ��� � _ `��.� -��v �lil/atic� �4 uL �.v� q�2 c J So�G�cf�- <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � � �L� <br /> CONTRACTOR � i � � ADDRESS CITY2IP PHONE <br /> n <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �,� �. ��-- _Electric�Gas_Olher <br /> WORK DESCRIPTION <br /> ����m o�� (��-�--�-�N s-�cp� � p ��IL �- �- P 1 ►��� <br /> � V'� � � � �, I N -S'1�c S p ►'�C '���c�r�c�-�� �-'11L S� �c <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling cnits <br /> Balhtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Waler heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clolhes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/elc.) Exhaust tan <br /> Back(low preventer Heal pump <br /> Urinat Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodslove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TN(CODE IS 3105 <br /> I hereby cerilify lhat I have read and examined this application and know lhe same to be true and correct. All provisions o(laws and <br /> ordinaces governinc�this type of work will be complied wilh whelher specified herein or not.The granling of a permit does not presume <br /> to give aulhority lo violale or cancel tho provision of any olher slale or local law regulaling construction or the peAormance of <br /> conslruction.That I am authorized by the owner of lhis property lo perform the work(or which application is made and I comply with the <br /> Slale CoNraclors Law 18.27 RCW and 296.200 WAC. <br /> SignaWre o OwnedContracrodAulhonzed Agent Dale � <br /> C/ I <br />