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„ . <br /> '� <br /> PE�MIT APPLICATIO� <br /> CITY OF EVERETT PERMIT SERVICE8 � <br /> 3200 CEDAR STREET,EVERETT�WA 98201 <br /> 425-257-8810—FAX 425-257-8a57—www.ewroKMra.a�p <br /> wro M a �,/ <br /> APPUCATIONS ARE ACCEPrED PROM!AM TO 4�IA ' � ”7`�f/'n <br /> aliE ADDR�ss PARCEL TAX I.D.t � ` r//_ <br /> �� W/� �v <br /> ts �or No. s�oac �T <br /> oesc. <br /> ��,� �. �o�- 5�� ,rr� s� sw f���/�o �n <br /> TENANT NAME ' CONTACT fOR PEIIMIT �� <br /> �� a,u a�--- I gc�.vt �ovwos 3�o 't�o eSZS <br /> �oo�as crtnar wa�c <br /> coMrn.ucer�r / �C <br /> USE OF BUILDINO �T�� ����� <br /> Q ...-� — <br /> E,� _�s_�� I IOp b �' <br /> WORK EBCRIPTION <br /> �� � ��� ��� �SS, '�.�.�/'��� <br /> PLUMBIN�i ME ICAL <br /> NO. TYPE OF FIXTURE OR IiEM NO. TYPE OR RD(11NIE OR flEM <br /> Toflet _ AIC—ak handllrg u�ib <br /> — �m�b _ Fo�ced ak eyatema <br /> Lavatory(wash basin) — �a�� <br /> Shower ,_ Waterhealer <br /> Kftchen sink&disposal _ Gas fireplace <br /> Dlahwasher — �s��° <br /> Cbthes washer _ CbMes dtyer <br /> Water heater _ Range hood <br /> Sink(service/badmop/etc.) _ E�d�auslfan <br /> Backlbw preventer _ Heat pump <br /> Urinel _ Unft healer <br /> Drinking Fountain _ ��ler <br /> Floor drain — R°�°�� <br /> — Woodstove <br /> _ Grease trap — py�er <br /> Roof drains — <br /> Other — <br /> CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritlfy thal I have read and examined this app�ication and know the same to be hue and conec;t. AA provisio�s of Iewe a�d <br /> ordinaces goveming this type ot work will be wmplied wilh whether specifled hereln or rwt The graM��p oi e pertNt does not peeume <br /> to give eulhorfly to vblate or cancel the provision of any other state or bcel law reguladnp conatrucdon or tlre per�omiance of <br /> construc0on.That I am authorized by the owner of this property lo peRortn tlie work for whkh applicadon la made and 1 comply wiMi ths <br /> State Contractors Law 18.27 RCW and 296200 WAC. <br /> Signature o ner ntractorlAutho zed Agenl ate �I <br /> Z <br />