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P��tMIT APPLICATI��� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org /, v�Z`� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEB1T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.* ��T x <br /> 'C�� ��1�-i`r� _ I 1- � <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYRIP PM N <br /> �,L��s .�.ti�.s7�"��',�' ��G /;9�o d/w�' S�� G��� � <br /> iENANT NAME CONTACT rOR PERMIT PHONE <br /> " r / /C �r2� I Cr��s ,�au.- C�Zr) s'� 76� <br /> CONTRACTOR ADDRES� CITY2IP PHONE <br /> CONTR.LICENSE t � <br /> USE OF BUILDING ��� HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���� P�� ��y��/,�,� _Electric _Gas_Other <br /> WORK DESCRIPTION / ry, ��-� <br /> „r n G �►�/�f '7� <br /> � � �� p.�tf�r� ��.� -'�x�' � -, -:-f:� r,�,�✓ — 1 <br /> J <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUCTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> ( Toilet _ A1C—airhandlingunits <br /> / Bathtub _ Forced air systems <br /> � Lavatory(w�sh basin) _ Gas piping <br /> Showar _ Waterheater <br /> � � Kitchen sinF:8 disposal _ Gas fireplace <br /> Dishwashar _ Gas range <br /> Clolhes washer _ Clothes dryet <br /> Laundry tray _ Range hood <br /> Sink(�ervice/badmop/etc.) _ Exhaustfan <br /> Backflow prevenler _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fourtain _ Boiler <br /> Floor drain _ Refigeratian <br /> Grease trap _ Woodstove <br /> Roof drains _ Other <br /> Other -- <br /> CITY OF EVERETT LOCAL SALES 7AX COOE IS 3105 <br /> � I hereby ceritify that I have read and examined this application and know the same to be ttue and corred. All provisions of laws and <br /> ordinaces goveming this rype of work will be complied with whether specified herein or not.The granting of a pertnit does not presume <br /> to give authonty to violat or cancel the provision of any other state or local law regulatin�consWctloo or the pertormance of <br /> constructio �That I am�thorized by owner of this property lo perform the work for which applicatlon is made and I comply with the <br /> State C ractors La 18.2 RC�Y�an 296.200 WAC. <br /> � �� n <br /> Signature of OwnerlCo or/ ut ed Agent ate <br />