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PERMIT ApPLICATION �� <br /> CITY OF EVEl2ETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> -. APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# R/M,!,Tj�# f/� <br /> 1Aoo IN u5� 51 - B�Ct F - SttEti aS��I0�0040�5C� � �" - l� �l <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITYIZIP PHONE <br /> �ANAT�GCII �Eve�o�n»*�7' Il�4co So�TM�N��e¢ Wnv I�wiv.1,JA 9si98 <br /> TENANT NAME CONTACT FOR PERMIT: uam Mllinr PHONE:425-885-9100 <br /> CONTRACTOR:Univorsal Machanieal Sorviea AD�RESS:P.O.Box 2fi49 CITYIZIP:Rrdmond,WA 98073 PHONE:425•885-9100 <br /> CONTR.LICENSE# UNIVEM5132JF <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � OFF�:.f/wA2ed�E _Eledric �Gas_Other �y,2/O�' <br /> WORK�ESCRIPTION �NSf'��� Two(�� UNIT HN�RS�of7E (�) VenmunoN FnH, iWo(x) Cins UunEiS. <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEhI NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) 2 Ga�piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas freplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(sen�ice/bar/mop/etc.l I Exhaust(an <br /> = BackFlow prevenler Heat pump I <br /> Urinal 2 Unit heater <br /> _ Drinking Founlain Boiler I <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know lhe same to ve lrue and correct. All pro��isions of laws and <br /> ordinaces governing this type of wcrk will be complied wilh whelher specified herein or noL The grantin9 of a permit does not presume <br /> to give aulhority to violate o�ncel fhe provision of any other state or local law iegulating construclion or the performance of <br /> construction. Tha!I a�oCRbrized by the owner of lhis property to periorm the work for which applicalion is made and I comply wiih the <br /> State Contrectors I,aW 1827 RCW and 296.20G WAC. <br /> // . =i__� - �/S� <br /> � <br /> Signatur of OwnedContractoi/Authorized Agent ' ,Aate <br /> � � <br /> / <br />