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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.everettwa.org ������ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> � �---� <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT A \\ <br /> 516 Pilchuck Path � � 010640•000-054•00 ' i ��3� I <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION X _/ <br /> DESC. yq � -- � <br /> WN R AODRESS CITY2IP PM NE <br /> Beimonte Heights LLC 9514 4lh St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> Brittney Lundberg 425•953-1470 x123 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> Belmonte Heighls LLC 9514 4th St. NE Suite#102 Lake Stevens, 98258 425-953-1470 <br /> CONTR.LICENSE X <br /> BELMOHL944B0 <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleclric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#2oa <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlI(TURE OR ITEM NO. TYPE OF Fl%TURE OR ITEM <br /> � Toilet A/C–air handling uni�s <br /> 2 Bathtub 1 Forced air sys�ems <br /> � Lavatory(wash basin) 4 Gas piping <br /> � Shower 1 Water healer <br /> 1 Kitchon sink&disposal 1 Gas fireplace <br /> 1 Dishwasher 1 Gasrange <br /> 7 Clothes washer 1 Clothes dryer <br /> Waler healer 1 Range hood <br /> Sink(serviceR�aGmop/e�c.) 5 Exhaust fan <br /> Backllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fou��ain _ Boiler <br /> Floor drain Relrigeration <br /> Grease trap _ Woodstove <br /> Rool drains Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ceritily that I have read and ezamined Ihis application and know the same to be lrue and correct. All provisions ol laws and <br /> ordinaces governing Ihis type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision ot any other state or local law regulating construction or the peAormance ol <br /> construction. That I am authorized by ihe owner of this property to perform the work for which application is made and I comply with ihe <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> �l���Ir �� <br /> SignaWre of Ownr /Contractor/Authorized Agent Dal�— � <br /> � Z <br /> � <br /> � � _ <br /> �_ <br />