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P�RMIT APPLICATIUN -� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE'f, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857—w�,vw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���/� �� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI # <br /> 7 ,�,� � �t'�7-OD,S <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYI7.IP PHONE <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR AODRESS CITY/ZIP PHONE <br /> CONI'R.LICENSE# <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORI< <br /> Eleclric Gas Other /� (�(/ ' <br /> WORK DESCRIPTION , /- <br /> ,l�I2�G�1�1�� ��2�����c�.�?�'L(� �'-�aC��C�� <br /> c�/c�1�q C� <br /> LUMBI MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTUHE OR ITEM <br /> Toilel A/C–air handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clolhes dryer <br /> Water healer Range hood <br />- Sink(service/bar/moplelc.) _ Exhaustian <br /> BackOow prevenler _ Heat pump <br /> Urinal Unit healer <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap _ Wood�tove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EV[RETT LOCAL SALES TlilC CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correcL All provisions of laws ar�d <br /> ordinaces governing lhis type of work will be complied wilh whether specified herein or noL The granting of a permit does not presume <br /> lo give aulhonty lo violate or cancel lhe provision o(any other state or local law rec�ulating constmclior or Ihe pedormance of <br /> conslruclion.That I am authorized by ihe oyvner of this property to peAorm the w•ork for which application is made and I comply�vilh the <br /> Slate Contraclors Law�27 RCNJ and_�46.2D WAC. <br /> �': <br /> � <br /> , � �� i�� ;r,-��' iv�3�-G� <br /> Sigr�ature of OwnedConlraclodAuthonzed Agent Date <br /> —J <br />