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, <br /> -- — — -- -�u_c��� <br /> � PErtMIT APPLICATIOev <br /> C17'Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810- FAX 425-257-8857 -www.everettwa.org <br /> /l �� APFLICAI"IONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 _ a„'3� 7 <br /> SIT��E AJ�D_DRESS �I� ,f PARCE:.TAX I.D.# PER(�11_T# �`�� I <br /> `lx�lT'� i. l� r %/ <br /> LEGAL LUTNO. BLOC �RACT ', <br /> DESC. II <br /> OWNER ADDRESS CITYIZIP PHONE <br /> ....r1A�T NAME CONTACT FOR PERMiT PHONE <br /> _" � I��-./�GX — �U�'/��II�t �YlI�� l GZ,�YtC� i3�(.p ' �CnO2 -�� .�,�- � <br /> CONTRACTORy�'lp��_� rn��`��IC6L�1 ADDR SE S ��„'�T t�3� CI,T,Y��I-^��hv� HC,ZS ' (�V✓-��� <br /> � Ilt�f � t,cCJl/ �' cK, <br /> CONTR.LICENSE# <br /> I���C�VI f I�YI L < <P�I!'� c� 4--l -U f <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I �L,a7` - / J�Electric �as_Olher I��r ��O OU II <br /> W � <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICF�L <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FI%TURE OR ITEM �, <br /> _ Toilet A/C—air handling unils ��{ -{p P�(,V\�1""� � <br /> Bathtub Forced air systems <br /> _ Lavatcry(wash basin) � Gas piping U���� � I <br /> Shower Water heater - � <br /> = Kitchen sink 8 disposal _ Gas fireplace /� `..\ <br /> Dishwasher Gas range <br /> I _ Clothes washer � _ Clothes dryer <br /> Laundry tray � Range hood <br /> _ Sink(service/barlmop/etc.) �,`' � Exhaust fan w/d��+ - �,�(,�� <br /> Backflow preventer � ��`� Neat pump � <br /> _ Urinal ��', p� � Unitheater 9� ; / � <br /> _ Drinking Foun�ain `� ���� _ Boiler `' <br /> Floor drain �, t �v` _ Reirigeration <br /> Greasetra 1 � `� Woodsto �� <br /> _ Roof drains ; '��,�� , � � Other �r�.�Ltl�'ln�� N��� • <br /> Other A � �� <br /> _ � ��� \�� <br /> l'ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> I hereby ceriti(y thal I have read and examined lhis application and know the same to be lrue and correct. All provisions of laws and � <br /> ordinaces goveming lhis type ot work will be complied with whether specified herein or noL The granting of a permit does not presume i <br /> � to give autho y to violale or cancel the provision of any other state or local law regulating construction or the performance of <br /> constJ�ion. hat I am authorize y the owner of this property to perfonn ihe work for which appliwtion is made and I comply with the <br /> I St t€Conlra�ors La�v 18.27 RC an 296.200 WAC. <br /> � i � <br /> � •�w ,� `�.�—� � <br /> o Owner/ tractorlA Ua rize ent Date II <br />