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� t <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 �ERMD� O(� <br /> 532 Pilchuck Path 010640•000-062-00 �� <br /> l, / <br /> LEGA LOT NO. BLOCK TRACT CR SUBDIVISION A' <br /> DESC. sZ <br /> OWNER A�DRESS CITY2IP PMONE <br /> Bcdroonte Naighls LLC 9514 4th SL NE Suite#102 Lake Stevens,98258 425•953-1470 <br /> TENAN7 NAME I CONTACT FOR PERMIT PHONE <br /> Brittney Lundberg 425-953-1470 <br /> CONTRACTOR AOORESS CITY2IP PHONE <br /> Belmonte Heights LLC 9514 4th St. NE Suile#102 Lake Stevens,98258 425-953-1470 <br /> CONTR.LICENSE M <br /> BELMOHL944B0 <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric X Gas_Olher <br /> WORK DESCRIPTION <br /> Basic#204 <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FlXTURE OR�TEM NO. TYPE OF flXTURE OR ITEM <br /> �_ Toilcl A/C–air handling uni�s <br /> 2 Bathtub 1 Forced air systems <br /> � Lavalory(wash basin) 4 Gas piping <br /> � Shower 1 Water heater <br /> 1 Kilchen sink 8 disposal 1 Gas firepiace <br /> 1 Dishwasher 1 Gas range <br /> 1 Clothes washer 1 Clothes dryer <br /> Water heater 1 Range hood <br /> Sink(service�barlmop/elc.) 5 Exhausl fan <br /> Bac4flow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain _ Boiler <br /> Floor drain Refrigeration <br /> Grcase irap Woodstove <br /> Rool drains Other <br /> Olher <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br /> I he�eby carilily thal I have read and examined Ihis application and know lhe same to be true and correct. All pravisions of laws and <br /> ordinaces governing this type of work wi!I be complied with whether specilied herein or not.The granting ol a permit does not presume <br /> to give authority to violate or cancal the provision ol any other state or tocal law regulating consiruction or the perlormance ol <br /> conslruction.Thal I am authorized by the owner of lhis property to perform the work lor which application is made and I compiy with Ihe <br /> State Contractors La�v 18.27 RCW and 296200 WAC. <br /> - -0 <br /> gnaWre of Owner/C rac or/ uthorized Agent ate � <br /> l.� <br />