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O "6 `d <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. # P�RMIT p <br />LGf 71 <br />LEGAL LOT NO. BLOCK TRACT�y r <br />'��a S <br />DESC. �- l?2 <br />OWNER ADDRESS CITYIZIP PHONE <br />P.ca . �DK I '1+.Vjj-U�o 9K-1V— <br />TENANT NAME <br />' - <br />CONTACT FOR PERMIT PHONE (' <br />w\kV-('L. ev.{ZRl/ L40 L���1{�[ti%r�i.JA-� t(2 <br />/ <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE p <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />_Electric %Gas _Other <br />I <br />WORK DESCRIPTION <br />t2'�zl..l <br />Y�,t_; Y <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toilet � A/C - nir handling units <br />Bathtub Forced air systems <br />Lavatory (wash basin) _Gas piping <br />Shower _Water healer <br />_ <br />IGtchen sink 8 disposal _Gas fireplace <br />_ <br />Dishwasher _Gas range <br />_ <br />Clothes washer _Clothes dryer <br />_ <br />Laundry tray Range hood <br />_ <br />Sink (servicelbar/mop/etc.) _Exhaust fan <br />_ <br />Backflow preventer Heat pump <br />_ <br />Urinal Unit healer <br />Drinking Fountain Boiler <br />Floor drain _Refrigeration <br />_ <br />Grease trap Woodstove <br />Roof drains Other <br />Other _ -- <br />CITY OF EVERETT LOCAL SALES 1'A?' CODE IS 3105 <br />I hereby cerility that I have read and examined this application and know the tame to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />or the performance of <br />to give authority to violate or cancel the provision of any other state or local law regulating cons,. action <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.?W-R}W and 296.200 WAC. <br />Signature of Owner/Contrector/Aulhon��Ac ant Da a I/ <br />L <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8310 —FAX 425-257-8857 — www.everettwa.org <br />