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i -- <br /> P�RMIT APPLICATIVN <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 3 ��S—�,6 <br /> SITE ADDRESS PARCEL TAl(I.D.N PE IT f <br /> ' D.,r G� 600 � 3ss-�t-Qso--o3� � <br /> LEGA l0T NO. BLOCK TRACT <br /> DESC. .3 t{ � �I S .E_vQvGT T _ � <br /> OWNER ADDRESS CITY2IP PHONE G &03-7 <br /> � 151Z I�Q�s�N waY L�l r�n%w;x�o � � <br /> TENANT NAM � CONTACT FOR PERMIT PHONE <br /> /�TcFek-Za,e,e�ti .��(aeQr{-��e ,�,�h ,106 • 7S0-sv �o <br /> CONTRACTOR ADDRESS CRY21P PHONE <br /> CONTR.LICENSE N �(,�,�h p 1� <br /> USE OF BUILDING HEAT OURCE CONTRACT PRICE OF WORK <br /> s.�,-�.� _ � _ °° <br /> ElecUfc Gas Other �� <br /> WORK DESCRIPTION � / R � 7 3 — <br /> �-2.u�- '� o��w-� n- _ - 1 J <br /> PLUMBIYG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FU(TURE OR ITEM <br /> Toilet AIC-air handling units <br /> � Balhtub Farced air systems <br /> Lavatory(wash basin) Gas piping <br /> �� Shower Walerheater <br /> — �ilchen sink 8 disposal _ Gas fireplace <br /> ishwasher s range <br /> � Cl�iti@s washer CI es dryer <br /> Waterlwaler � Ran hood <br /> � Sink(ser�ic�e/badmopletc.) Exhaus an <br /> _ Backflow pr2•+enter _ Heat pum <br /> _ Urinal �� Unit heater <br /> Drinking Fountaim, Boller <br /> Floordrain `, Rehigeration <br /> Grease trap Woodstove <br /> Rooi drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAI(CODE IS 3705 <br /> I hereby ceritify that!have read a^d examined this application and know the same to be We and cortect. All provisions of laws and <br /> ordinaces govorning this type ot work will be complied with whether specified herein or not.The granting of a pertnft does not presume <br /> to give authority to violate or cancel tho provision of any other state or local law reguladng construction or lhe perfortnance of <br /> construction.That I am authorized by tha owner of this properry to perform the woric for which application is made and I comply with the <br /> Stale ontrectors Law 827 RCW d 296.200 WAC. <br /> � ( � a /a2S- o � <br /> ignatur of OwnedCon raclorlAuthorized Agent Dale ,' <br /> 2 <br />