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PtRMIT 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 <br /> SLTE ADD ESS ,y PARCE�TAX I.D.q PERMIT If <br /> L\J G� G� /�1 VP J'1 I�t � � � 7U�- I � <br /> LEGA LOT,�J0��2 O� �^�C�'O TRACT OR SUBDIVI51 N# ,. <br /> DESC. ` / Lj� <br /> OWN A DRESS CITY2IP PHONE <br /> �i c �� Q ro� Su I� i va� I �1.2-9 Rucl�er /�ve.�-E�—�e—ret���8Z4� (yZS?,ZS�►;7�5 <br /> TENANT NAME r t / CONTACT FOR PERMIT � PHONE/(I''r�23I-q70� <br /> ,�, 1 we�k L'IL�7 <br /> (�I��� �n��fy 0� �t"e���y �l�orneS E�JIfUL <br /> �N RAC R DRA�� I IZ1�6N�— <br /> � wh�r <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��I I'1 C��e �UvYi I+y R�S��N���e �Electric �Gas_Other <br /> WORK DESCRIPTION <br /> Dc� ��of�s� �a �'-f of tl�e 1�ct�J i«� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Balhtub Forced air systems <br /> L2vatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal _ Gas Tireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clothes dryer <br /> Water healer Range hood <br />- Sink(serviceNar/moplelc.) _ Exhaust fan <br /> Backllow preventer _ Heat pump <br /> Urinal Unil hea�er <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodslove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br /> I hereby ceritify that I have read and ezamined this application and know lhe same to be true and correct. All provisions of laws and <br /> ordinaces governing this type oi work will be complied wilh whether specified herein or noL The granting of a permil does nol presume <br /> to 9ive aulhonty to violate or cancel the provision of any olher slale or local law rec�ulating construclion or Ihe performance of <br /> construction.Thal I am authorized by the owner of lhis property lo periorm the work tor which application is made and I comply with the <br /> Stale Contradors Law 18.27 RCW and 296.200 WAC. <br /> , , i, �,.,� �/lti--�-�-�'_� V ��V/ <br /> Signature pi OwnedContractor/Aulhorized Agent Date <br />