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� . <br /> PERMIT APPLICATION ! <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � 7Qj-4.� <br /> SITE ADDRESS . ,) PARCEL TAX I.D.N PER p /�� <br /> 506 Pilchuck Path h� 010640•000•049•00 � 7W -,� <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. qg <br /> OWNER ADDRESS CITY2IP PI10NE <br /> Beimonte Heights LLC 9514 4th Sl. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> BrittneyLundberg 425-953-1470 x123 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> CONTR.LICENSE ff <br /> BELMOHL944B0 <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric _X Gas_Olher <br /> WORK DESCRIPTION <br /> Basic#204 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTUHE OR ITEM NO. TYPE OF Fl%TURE OR ITEM <br /> � Toilet A/C-air handling units <br /> 2 Bathtub 1 Forced air syslems <br /> _q_ Lavatory(wash basin) 4 Gas piping <br /> 1 Shower 1 Water hea�er <br /> t Kitchen sink&disposal 1 Gas fireplace <br /> 1 Dishwasher 1 Gas range <br /> 1 Clolhes washer 1 Clothes dryer <br /> Water heater 1 Range hood <br /> Sink(scrvice�bar/mop�etc.) 5 �xhaust lan <br /> Backllow preventer Neat pump <br /> Urinal Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grease irap _ Woodslove <br /> Raof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS�105 <br /> I hereby ceritily that I have read and ezamined this application and know the same to be irue and correct. Ail provisions of laws and <br /> ordinaces governing this type of work will be complied with whelher specified herein or not.The granting ol a permit does not presume <br /> to give authority lo violate or cancel ihe provision of any other state or loca�law regulating construction or the pertormance oi <br /> construction. That I am authorized by Ihe owner ol this property to perform ihe work for which application is made and I comply with the <br /> Slate Co Iractors Law 1827 RCW and 296.200 WAC. <br /> t,� � ' ' �, i� ' � " � �G `�j Z� 0� <br /> gnature ot OwnerlCon actot/ uthorized Ager�t D e //� <br /> L <br /> �il � <br />