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PE�tMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICF_S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � -► S�'O7 <br /> SITE ADDRESS� � � y��PARCEL TAX I.D.# PER�_#` C �C� <br /> ' / (JI.J � � � .l- i <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> �s ` �IL � c4c � ° �� s9-�i7z <br /> TENANTNAME I CONTACTFORPERM�T PHO E <br /> c,-_^ <br /> CONTRACTOR ADORESS CITY2IP PHONE <br /> CON1R.LICENSE# <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> � Electric Gas_Other <br /> WORK DESCRIPTION ����^ l I T I� �� "�I��1��� <br /> C.i L.� <br /> PLUM8ING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYP�OF FIXNRE OR ITEM <br /> Toi�et A/C–air handlin, �.iits <br /> Balhlub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen�ink&disposal _ Gas fireplace <br /> Dishwasher Gas renge <br /> Clothes washer Clothes dryer <br /> Waler healer Ran�e hood <br /> S�nk(service/badmop/etc.) Ezhaust fan <br /> Backllow prevenler _ Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> — i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereb} ceriti(y that I have read and examined this appiication and know the same to be true and correct. Ail provisions of laws and I <br /> ordinaces governing this rype ot wor will be corrplied wilh whether spacified h�rein or not.7he granting of a permit does not presume <br /> lo i aulhority to violate or c el tl�e provision of any other state or local law regulating construction or lhe perfoimance oi <br /> c s uction. ha I ized by�the owner of th�s propr.rty to perform the work for which application is made and I comply wilh the <br /> St le r cl ���-7 RCW nd 296200 WAC. � <br /> _� � <br /> Sig t re ot OwnedConlraclor/Authorized Agenl ate <br />