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1 � l• <br /> d <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 /> SITE ADDRESS PARCEL TAX I.D.M PERMIT N <br /> 518PilchuckPath „�� Z 010640-000-055-00 f '��� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. 55 <br /> OWNER ADDRESS CITYRIP PHONE <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425•953-7470 <br /> TENANT NAME CONTACT FOR PEHMIT PNONE <br /> Brittney Lundberg 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# <br /> BELMOHL94480 <br /> USE OF BUILOING I — HEAT SOURCE I CONTRACT PR�CE OF WORK <br /> Electric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#204 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM N0. TYPE OF FI%TURE OR ITEM <br /> 3 Toilcl NC–air handling units <br /> 2 BalhWb 1 Forcedairsystems <br /> � Lavatory(wash basin) 4 Gas piping <br /> 1 Shower 7 Waler heater <br /> 1 Kitchen sink 8 disposal 1 Gas lireplace <br /> 1 Dishwasher 1 Gasrange <br /> t Clothes washer 1 Clothes dryer <br /> Water heater 1 Range hood <br /> _ Sink(servicelbar/mop/etc.) 5 Exhaust lan <br /> Backllow preven�er Heat pump <br /> Urinal Unit healer <br /> Drinking Foun�ain Boiler <br /> Floor drain Refrigeration <br /> Greasc Irep Woodstovc <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritily that I havc read and examined Ihis application and know ihe same to be true and correct. All provisions of taws and <br /> ordinaces c�overning this ty�e of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authoriry to vio�ate o•cancel the provision ol any other state or local law reguiating construction or the perlormance ol <br /> construction.That I am autnorized by Ihe owner of this property to perfcrm the work tor which application is made and I comply with the <br /> State Conlracrors Law 18.27 RCW and 296200 WAC. <br /> f���ll� � <br /> Signature of OwnedConiractor/Authorized Agent Oate I /� <br />