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�-- — <br /> � <br /> j PLRMIT APPLICATIGa�! <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAft STREE7, EVERETT, WA 98201 <br /> I 425-257-8810- FAX 425-257-8857 -www.everrottwa.org <br /> I APPUCATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT il <br /> ` � / •� ��0_5����. �'�-�-� c��� -� t -� y�i��)��� � G� <br /> LEGA LOTNO. BLOCK TRACT <br /> DES(:. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> + � �� � �� :�-' j'cl� �� ��>L � >/ , �.._'>` �?1 F��'L C. .C'.�(-� i-?S• �`��/"�, ? - <br /> TENANT NAME CONTACT FOR PCRMIT PHONE <br /> ,>;,;,;, , �>;: .� Y�c�c; �;�s- _ ,�/y_73L� <br /> CONTRACTOR AODRESS CIN21P PHONE <br /> CONTF2.LICENSE# <br /> iUSE OF BUILDING HEAT SOURCE CONTRAC7 PRICE OF WORK <br /> -i� Electric __Gas_Other I <br /> T <br /> WORK DESCRIPTION <br /> i / � 7 <br /> ���60 /� c•IJ �"� j � , ��I l ��') �... �� L�� 'i lc -� � �- i �c' f� ��[_( <br /> PLUMBING MECHANICAL <br /> I NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I Toilel lv�C-air handling units <br /> I _ 6alhtub Forced air systems <br /> � _ Lavatory(wasb basin) � Gas piping <br /> Shower Water healer <br /> _ Kitchen sink&disposal � Gas fireplace <br /> Dishwasher Gasrange <br /> Clo�hes washer Cblhes dryer <br />� I = Laundry lray = Range hood <br /> Sink(service/hadmr,p/etc.) Exhausl fan <br /> Backflow prevenler Heat pump <br /> � _ Urinal Unit heater <br /> Drinking FouNain Boiler <br /> I Fioor drain Refriyeralion <br /> � _ Grease Uap Woodstove <br /> II _ Roof drains Olher <br /> Other <br /> ICITY OF EVERETT LOCAL SALES TAX COOE IS 9105 <br /> II hereby cerilify that I have read and examined this application and know the same lo be true and correcl. All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or noL The granting of a permit does not presume <br /> I to give authonty to violale or cancel Ihe provision of any other state or local law reguialing construction or the performance of <br /> construction. That I am aulhorized Uy lhe owner o(this property lo per(or�.�the work tor which applicalion is made and I comply with lhe <br /> Stat Contractor�La� 10.27 RCW anA 296200 WAC. <br /> �It%`.^�,• ' ::, <br /> Sig ture of Uwn /Contra dAuthorized Ac�enl Date <br />