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P�r2MIT APPLlCATIOnI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, N!A 98201 <br /> 425-257-8810— FP.X 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS / PARCEL TAX I.D.# PEI�MIT# <br /> � ;�'-�? (-.�� ��,�,� ��;! ���'te; Oo5�3 j•�7Sc7 /3 � � �7��� •�� <br /> LEGAL LOT NO: BLOCK TRACT OR SUBDIVISION# <br /> DESC. �7 J-���:�Z�2� j ' �:� �� C�. %� _ I ` -� S� ' `, `i� �, ' s� t <br /> OWNER ADDRESS � CIN/ZIP PHONE <br /> � � �/�. . ^ '{� I <br /> < ;'- l� „-�. r .,�'c � _ �f� � �_ `� '–/ <br /> i� �- <br /> TENANT NAME CONiACT FOR PERMIT PHONE <br /> �� i ii� i L � L.,� E-MAIL <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE <br /> CONTR.LICENS[# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> _/��J „ , _Eleclric /�Gas_Olher —/� Z ZL, � <br /> iy <br /> WORK DESCRIPTION <br /> i <br /> � �' -,� �<<�.�� :��r/c,C <br /> PLUMBIN MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITER1 NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C-air handling units <br /> 13alhtuh Forced air sysiems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler healer <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clo�hes washer Clolhes dryer <br /> Water healer Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> Bachtlow prevenler Heat pump <br /> Urinal Unit healer <br /> Drinkinc� Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodslove <br /> Roof drains Olher <br /> Olher <br /> I <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 I <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correcL All provisions of la�vs and <br /> ordinaces governing lhis type of work will be complied wilh whelher specified herein or not.The c�ranting of a permit does not presume <br /> to give authoriry to violate or cancel lhe provision of 2ny other stale or local la�v reg laliny construction or the performance of <br /> construction.Thal I am authorized by the o�vner ot ihis propeiiy lo perto v C� (o which application is made and I comply wilh lhe <br /> State Con�raclors Law 18.27 RCW and 296.2b0 WAC. ���� // � � <br /> � .- �-� ��_ . i . c._ . l,Ll%,: ;�� -z��-�'—�"' <br /> Signature of OwnedConlraclor/A�lhorized Agent Dale <br /> �__ _ �Z J <br />