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.. , <br /> c � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.+� I �fi IRT• <br /> ^� , 1 � �l'i rJc.�G.� OvG�o3 7C�vOoa3�/ I 11 91 D - Do l <br /> LEGA LOT N0. BLOCK TFIACT OR BUBdN310N i <br /> DESC. <br /> OWNER ADDRESS � CITY2IP PHONE <br /> Tini �GIJa,;�Trn�� �AT1'F�Soii/ 2�/3�f FgNR+l�.cn/ BC-vOf c'd�G�fl" Ldfi 9,�20 <br /> TENANTNAME I CON�ACTFORPEHMIT PM�ME <br /> E�IAIL <br /> M ec-NAnt.'�•�rL �= �. �3n� �h sr SF, 6✓�c�rT� �A� 9P:-o.� <br /> CONTA.LICENSE• <br /> /�1 EGfl�iA-iF ��1'Y �,Q <br /> USE OF BUILDINa I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ei�c� �a5_rnne� �y,as"/iZ <br /> WORK DESCRIPTION /� <br /> � � �� .t "� •-� � <br /> � ��e <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FlXTURE OR ITEM NO. TYPE OF FlI(TURE Oli ITfM <br /> Toilet AIC—air handling units <br /> Bathtub Forced afr systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink R disposal _ Gas fireplaco <br /> Dishwasher _ Gas rangc <br /> Clothes wa�her _ Clothes dryer <br /> Water heater _ Rango hood <br /> Sink(servico/barlmopletc.) _ Exheust tan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain Boiler <br /> Floor drain _ Refrigeralion <br /> Grease trap _ Woodstove <br /> Roof drains _. aher <br /> Other — <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know ihe same to be true and correct. All provisions ot laws and <br /> ordinaces governing this type oi work will be complied wilh whether specified herein or not.The granting of e pertnit does not presume <br /> to give authority lo violate or cancel the provision of any other slale or local law regulating consiruction or the peAortnance of <br /> construction.That I am authorized by lhe owner of this pmperty ro pedorm the work for which application is made and I comply with the <br /> State Conlradors Law 1827 RCW and 296200 WAC. <br /> �'-,� K ..,..��� ����' °j <br /> Signature of ner onirector/ ut orized Agent ate <br />