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� <br /> P�RMIT APPLICATIC�N <br /> CITY OF EVERETT PERMIT SERVICES �� ,.-7 -- oS <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-fi857— www.everetbNa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> SI7E ADDRESS PARCEL TAX I.D.;� P IT# <br /> � 13b Sr r�e�eT'�titn�( l.v�� ' ll � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER i ADDRESS CIN/ZIP PHONE <br /> ���d �sj— ��e;e {-r �G� �-/N�5(,,/ �rf��, Sr/�.�wF��t-C�4 �85�z ��cx� <br /> TEN+�ANT NAfdE ONTACT FOR PER�dIT PHONE <br /> C�,�L1 «� c�S �oE�/.3r�d��ti,�,i. .���D L�G�y o2� �, y. <br /> CO TRACTOR A�DRESS CITY/ZIP PHONE <br /> ��t�� .�Stev�.5 Mec�,. /�vo ��Q�,_ �- Seu(-tit 2�c� 9�3-G�3� <br /> CONTR.LICENSE� �/�/« S �"!(�Z <br /> �t tizre sM 9�� �� y 9Bi�3 y � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �p��� ` _Electric �as_Other 7S�U <br /> WORK DESCRIPTION <br /> L xfn.,t j�..c+�i].,c�/� ��r� �,c f�7`r.,� C�,�:r <br /> .LnSts.l. 0��.�„p•- f%oJ(.lut.i .Q�r7GL"f•��Sc,,� C��•(P•N['.l � J� /WC� �-�,t�` �n.$ . <br /> � <br /> —f-n�''ill 'j.M;� ,.3ti'�H�n�,.., �x/.AuSr �'�nS. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIX"i URE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> i <br /> Toilet A/C—air handling units � <br /> Bathtub � Forced air systems <br /> _ Lavatory (tivash basin) _ Gas piping <br /> Shower Watar heater � <br /> Kitchen sink&disposal Gas fireplace i <br /> I _ Dishwasher _ Gas range I <br /> Clothes washer Clothes dryer � <br /> Laundry tray _ Range hood <br /> i Sink(service/badmopletc.) < Exhaust fan <br /> ' Backflow preventer _ Heat pump <br /> Unnal Unit heater <br /> Drinking Fountain Boiler <br /> ' Floor drain � Refngeration <br /> Grease trap Woodstove <br /> �� _ Roordrains _ O[her <br /> Olher <br /> C CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and ex2mined this application and know the same to be true and correct. Ail provisions of laws and I <br /> ordinaces goveming this .rype of work will be complied with�vhether speci�ed herein or not The graniing of a permit does noe presume � <br /> ro give authority ro violate or cancel the provision of any other state or!ocal law regulating construction or the performance uf ! <br /> construction. That I am authorized by the ovmer of this properry to perform the�.vork for�vhich application is made and I comply wiih the i <br /> State ContractorsLaw 18�7 RCW and 296.2DO WAC. , <br /> � �^� !/�,� � i <br /> Signatura oi O�vnerContracrorlAuchorized Agent � Date � <br /> . I <br />