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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 PNO <br /> SITE ADDRESS PARCEL TAX I.D.M I �IjEF�AIT N� <br /> 526 Pilchuck Path 010640•000-059-00 �� �b � (�/ ' <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N <br /> DESC. Sg <br /> OWNER ADDRE CITY2IP PM E <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425-953-7470 <br /> TENANT NAtAE CONTACT FOR PERMIT PNONE <br /> Brittney Lundberg 425-953•1470 <br /> CONTRACTOR ADDRESS CITY2IP PNONE <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425•953-1470 <br /> CONTR.LICENSE! <br /> BELMOHL944B0 <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleciric X Gas_Other <br /> WORK DESCRIPTION <br /> Basic#203 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> 3 Toilel A/C–air handling units <br /> 2 Bathtub 1 Forced air systems <br /> g_ Lavatory(wash basin) 4 Gas piping <br /> 1 Shower 1 Water heater <br /> 1 Kitchen sink&disposal 1 Gas lireplace <br /> 1 Dishwasher � 1 Gasrange �/ <br /> 1 Clolhes washer 1 Clolhes dryer <br /> _ Water healer 1 Range hood <br /> Sink(scrviccroadmop/elc.) 4 Exhaust lan <br /> Backllow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> floor drain Refrigeration <br /> Grease irap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%COUE IS 3105 <br /> I hereby ceritily that I have read and examined this applicalion and know the same to be lrue and correct. AI�provisions of laws and <br /> ordinaces c�overning this type ol work will be complied with whether specilied herein or not.The granting of a permit dces not presume <br /> lo give authoriry to violate or cancel ihe provision of any other state or local law regulating construction or the pedormance of <br /> construction.That 1 am authorized by the owner ol Ihis property to perform ihe work lor which appiication is made and I compty with the <br /> Slate Co tr Jgrs Law 18.27 RCW and 296200 WAC. <br /> ✓ ` _v <br /> SgnaWre ol Owner/Co tr ctor Authorize gent ate / <br /> rZ <br /> � <br /> � , . <br />