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c,,.,�,�,�. �'"r . t1- <br /> ( � <br /> PERMIT APPLICATION Zo�_ ���.oqo <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, 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 ADD ESS PARCEL TAX I.D.N ERMIT If <br /> , � — �� � H- ����o - 82 � <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER AUDRESS C:TY21P PNONE L04 •3%1 <br /> P� �oX dS� c.�o�J�w�lt w�r �9u�Z c2zf <br /> TENA T NAME CONTACT FOR PERMIT (�d e ` PHONE � <br /> C� � � r '}— / � . , E-MAIL I'OF CJ � °JD� I"I'Cu��^►�. <br /> LUT ADDRE55 � i—Z �y� <br /> Qufor E�rn�� <br /> CONTR.LICENSE N <br /> UnSE OFr BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> y\'��1 n �`I I _Eledric _Gas_Other /8� <br /> 1 ICti 7 <br /> WORK DESCRIPTION <br /> %C-:r'1'zn� I �'1'���'/7�C�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C–air handling units <br /> Bathtub _ Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clolhes washer _ Clolhes dryer <br /> Water healer _ Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal _ Unit healer <br /> _ Drinking Fountain ,_ Boiler <br /> Floor drain _. Refrigeration <br /> Grease trap ,_ Woodstove <br /> Roof drains _, Other <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3706 <br /> t hereby certify lhat I have read and examined this application and know the same to be true and correct. All provisions of laws end <br /> ordinances governing this type oi work will be complied with whelher specified herein or not.The granting of a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other slate or local law regulating conslruction ar the pertortnance ot <br /> construction.That I am authorized by the owner oi this property to perform the wotk for which application is made and I comply with the <br /> State Contractors Law 1827 RCW and 296200 WAC. <br /> � r ��� � / <br /> �'(� `/�vl-"� /o - �-�o �12 <br /> �naWre O neri�oMractor/ orized Agent Date � <br />