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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 32U0 C"rDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www•everettwa.org <br /> APPLICATIONS ARE AGCEPTED FROM 8 AM TO 4 PM <br /> PARCEL TAX I.D.# I PERMIT# <br /> �IT�j ADDRESS ,LI _ <br /> i �� 0 C� ,pti6l,WA . <br /> LEGAL LOT NO. ` BLOCK TRACT OR SUBDIVISION� <br /> DFSC. CITYIZIP PHONE <br /> ADDRESS <br /> OWNER <br /> I �� ' ��'� CONTACT FOR PERMIT PHONE <br /> TENANTNAME I <br /> E-MAIL <br /> ADDRESS CITYIZIP PHONE �L�\ <br /> CO RqCTOR I / p � <br /> !� ��b(1��vUPS� �`r`71�G���� '3�L \.��6 � `-,� ' SW �V(�� \��--�� �`�'l.��l. <br /> CONTR.LICENSE N��L � �-j��'.`�-� `t <br /> (� { CONTRACT PRICE OF WORK <br /> HEATSOURCE <br /> USE OF BUILDING I ?�Z�,i - <br /> ��`��/,y _Electric _Gas_Other <br /> WORK DESCRIPTION Q ��c�"'' �� • \ \���. - r � <br /> �{' ��-'"� I �. ��1Cv.l V2N'�A��c-I'�� �/il�J <br /> �i � ��k- re�.> G.�� ✓"�� �� <br /> �'_ <br /> �` MECHANICAL <br /> PLUMBING <br /> NO. I TYPE OF FIXTURE OR ITEM <br /> N0. TYPE OF FIY.TUP.E OR ITEM <br /> A/C–air handling unils <br /> Toilel Forced air systems <br /> Bathtub Gas piping <br /> Lavalory(Wash basin) — Water heater <br /> Shower Gas fireplace <br /> Kilchen sink&disposal Gas range <br /> Dishwasher Clothes dryer <br /> .� Clothes washer Range hood <br /> Water heater Exhaust fan <br /> � Sink (service/badmop/etc.) — Heat pump <br /> Backflow prevenler Uni�hea�er <br /> Urinal goiler <br /> Drinking Fountain — Refrigeration <br /> Floor drain Woodstove <br /> Grease lrap Olher�— <br /> Rcof drains — <br /> Other__ — <br /> I CIl'Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerlify lhat I have read and examined this application and know the same to be Vue and correct. All provisions of laws and <br /> ordinances governing this type o(work will be wmplied with whether specified herein or not.The granling of a permit does not presume <br /> to give authority to violate or cancel lhe pro'aision of any o�her state or Iecal law regulaling construction or the performance of <br /> construction.Thal I am authorized by the owner o(this property lo perform t � work for which application is made and I comply wilh the <br /> Slate Coptractor�Lavf 1827 f;�W an �.9G.200 WAC. / j �J <br /> _ � , ;;:, ��-� � � <br /> _;�� �,���: � � � � � �� _ <br /> Si�nature of OylnedCoNractor/Authu�ized Agent ' <br /> / <br />