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� • <br /> -� � <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.N .�ERMIT N / <br /> 528 Pilchuck Path 010640•000-060•00 D��J -� <br /> LEGA LOTNO. BLOCK TRACTORSUBDIVISION• <br /> DESC. 60 <br /> O NE ADDRESS CIri21P PMONE <br /> Beimonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I Brittney Lundberg 425•953•1470 � <br /> CONTRACTOR ADDRESS CITY2�P PHONE <br /> Belmonte Heights LLC 9514 4th St. NE Suite#102 Lake Stevens,98258 425-953-1470 <br /> CONTA.LICENSE�I <br /> BELMOHL94480 <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric X Gas Other <br /> WORK DESCRIPTION <br /> Basic#204 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> 3 Toilet A/C-airhandlingunits <br /> 2 Bathtub 1 Forced air systems <br /> � Lava�ory(wash basin) 4 Gas piping <br /> 1 Shower 1 Water heater <br /> 1 Kitchen sink 6 disposal t Gas lireplace <br /> 1 Dishwasher 1 Gas range <br /> 1 Clo�hes washer 1 Clolhes dryer <br /> Water heater 1 Range hood <br /> Sink(service'bar/mop/etc.) 5 Exhausl fan <br /> Backllow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Relrigeration <br /> Grcas�Irap _ Woodslove <br /> Rool drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing Ihis type of work will be complied with whelher specified herein or not.The granting of a permit does not presume <br /> ro give authority to violate or cancel the provision ol any olher state or local law regulating construction or the pedormance of <br /> ccnstruction.That I am authorized by tye owner ol�his property to pedorm the work for which application is made and I comply wi�h the <br /> State C n ractors La�v 18.27 RCW and 296.200 WAC. <br /> . / U <br /> Signature ol Owner oniractor/Authorized Agent Date / <br /> �(L <br />