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{ � <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRC-ET, EVERETT, WA 98201 <br /> 425•257-8810– FAX 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.N ERM N <br /> 522 Pi�chuck Path 010640•000-057-00 � �� 0�� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> LESC. 5� <br /> OWNEH ADDRESS CITY2IP PX E <br /> Belmonle Heights LLC �J514 4th St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-953-1470 <br /> CONTRACTOR ADDRESS CIri21P PMONE <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> CONTR.LICENSE N <br /> BELMOHL94480 <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#203 <br /> — PLUMBING MECHANICAL <br /> Np, TYPE OF FlXTURE OR ITEM NO. TYPE OF FIXTUHE OR ITEM <br /> � Toilel /VC–air handling uni�s <br /> 2 Bathtub 1 Forced air systems <br /> 4_ Lavatory(wash basin) 4 Gas piping <br /> 1 Shower 1 Waterheater <br /> 1 Kitchen sink 8 disposal 1 Gas fireplace <br /> 1 Dishwasher 1 Gasrange <br /> 1 Clolhes washer 1 Clothes dryer � <br /> _ Waterheater � 1 Range hood <br /> Sink(servicebar/mop/etc.) 4 Exhaust fan <br /> Backilow preventer _ Hea�pump <br /> Urinal Unit heater <br /> Drinkinc�Fountain _ Boiler <br /> Floor drain . aelrigera�ion <br /> Grease trap _ Woodstove <br /> Rool drains _ Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I hereby ceritify thal I have read and examined this application and know the same to be true and correct. All provisions ol laws and <br /> ordinaces governing this type of work will be complied with whether specitied herein or not.The granting ol a permit does not presume <br /> to give authority to violale or cancel the provision of any other state or local law regutating conslruction or the pedormance ol <br /> construction.Thal I am authorized by Ihe owner ot this properly to perlorm Ihe work lor which applicalion is made and 1 comply with ihe <br /> Stale Contractors Law 18.27 RCW and 296200 WAC. <br /> ) � � <br /> ignature ot OwnedC tract r uthorized Agen ate I <br /> '/� <br /> �' i <br />