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PL-RMIT APPLICATION <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 & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />H02—,5E BefZRMA <br />22J"-� <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />'0\U 1�- <br />ASS &blac►') y2s.1-AV-7&&y <br />ONTR�A�OR ADDs&SS CITY/ZIP PHO E <br />�YC�IJJV\ 1Y° rY0i2L��,Y� �D hSoX 12113 1'y�II I cye- _ �G/1S% <br />CONTR. LICENSE #apW �JV qH L1 1?906,Z /W 7W? <br />USE OF BUILDING <br />HEAT SOURCE <br />Electric Gas Other <br />I CON/T/RA�C�T PRICE OF WORK <br />_ _ <br />WORK DESCRIPTION <br />q0 mew 5*vb uys -gym exlsflvj I" drops <br />11�c� 2 �-e�✓��5 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water healer <br />Kitchen sink & disposal <br />Gas fireplace p <br />_ <br />Dishwasher <br />Gas range ry) <br />_ <br />Clothes washer <br />Laundry tray <br />Clothes dryer eV <br />Range hood (e`n <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan 11W1 <br />Backflow preventer <br />_ <br />Heat pump IIIYYY l O <br />Urinal <br />Drinking Fountain <br />Unit heater <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to bo true and correct. All provisions of laws and <br />ordinaces governing this type of w3rk will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancol the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.20P WAC. <br />Signat wner/COntrac or/Authorized Agent Date <br />