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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 PM 3 ... a 6 ..Q� <br /> SITE ADDRESS � /yo5 PARCEL TAX I.D.# PERMIT A� <br /> � ���� � � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRE55 CITY2IP PHONE <br /> WC�nc��iZu�-� I y01 t i,�� � Ev�f� �1�2o i Nz���ok-2.0� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> S 7�� E-MAIL <br /> CONTR.LICENSE# g�lY 1 �COi�l�l.(� �7�(.c G.Zs�i nl� Zo3c� P ( <br /> �A�t�12s 3z z- E���f �1�`�06� 20��`7 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��� �f���;� _Electric _Gas_Olher <br /> WORK DESCRIPTION <br /> �i,�� � ��� I,vOP�c� ����6TL�6(,1C�1� <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR I�EM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handlinc� units <br /> Bathlub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower �Vater healer <br /> Kilchen sink 8 disposal Gas tireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Waler hea�er Range hood <br /> Sink(service/badmoplelc.) Exhaust fan <br /> Back(low preventer Heat pump <br /> Urinal Unil heater <br /> Drinkin9 Fauntain Eoiler <br /> Floor drain Refrigeration <br /> Grease lrap Wordstovo <br /> Roo(drains Olher <br /> Othor _ <br /> CITY OF EVERETT LOCAL SALES TAX CODF IS 31CS <br /> I hereby cerilify Ihat 1 have re��d ar,d examined lh�s application and know ihe same lo be true aud correcl. All provisions oi laws and <br /> ordinaces governing lhis type oi::ork will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to giv, authonty to viB t or cancei!he provision of any other stale or local law regulating conslruclion or the performance of <br /> con�s clion.T al �m uthorize lhe owner o(lhis property to peAorm lhe wo;k(or which application is made and I comply with lhe <br /> Slal o trac ors w �27 R .V nd 29u.200 WAC. <br /> \� � w /�� <br /> 6ignal re of OwnenCoNrac�o Authorized Agenl ate <br />