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PERMIT APPLICATION <br /> CITY OF FVERETT PERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 90201 <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRFSS PARCEL TAX I.D.# P7�ERMIT# <br /> � Z L��.U"C..� C� IJ C/7 C�('Q <br /> LEGAL LOT NO. BLOCK 'i RACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE y��= <br /> C�� r!J I c� . GOUP 1"503 ����o-t�a G l,l�'�:`Z�,GGf-`I �y.�'L�3 .�aSS-651� <br /> TENANT NAME ---� CONTACT OR PERMIT PHONE <br /> Cl(YG�L L • L �'� E-MAIL <br /> �C f � AODR 5 ITYI 1 <br /> �� .t�G � . L� �Sv3 � ��' <br /> CONTR.LICENSE# ,� � �/ i Gt� yz� -3Sr-� s z� <br /> � <br /> USE OF BUILOING HEAT SOURCE CONTRACT PRICE OF WORK <br /> V�CC7/�'f — J� vSC _Electric _Gas r ou,er(NnNe� "' �d d � <br /> WORK DESCRIPTION „ <br /> �LLr C�OW�� �ICr Yci fe C�1�G1 /'L�/NUv�� G�[Zlo�,$ - pr,Pp <br /> \/ ,i � <br /> 5� �e {Yir Gt f /Cc-f Cc'�iCrP{c s/Q� -{z'v 2�2�1c.�=9, <br /> V �l <br /> PLUMBING MECHANICAL <br /> �0. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower VValer heater <br /> Kilchen sink&disposai Gas Tirep�ace <br /> Dishwasher Gasrange <br /> Cblhes washer Clolhes dryer <br /> Waler heater Range hood <br /> Sink (service/badmop/elc.) Exhausl fan <br /> Backllow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(rigeralion <br /> Grease Irap Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I hereby ceriti(y lhat I have read and examined this application and know Uie same to be lrue and correcl. AII provisions oi la�as and <br /> ordinaces governing lhis type of work will be complied wilh whelher specified herein or noL The granting o(a permil does not presume <br /> tc give authonly to violale or cancel the provision o(any other stale or local law regulating consWction or the performance oF <br /> conslruction.Thal I am authorized by lhe 6wner o(this property to peAorm the work for which application is made and I comply wilh lhe <br /> State Conlrectors Law 18.27 R�CW en��0 WAC. <br /> ��J� • 0`�' v `� -� ^� � <br /> Sic�naWre of OwnedComractor/Authorized A nl Dale <br /> �I <br />