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I��RMIT APPLICATIt�.N <br /> CITY OF EVERF�TT PERMIT SERVICES <br /> 3200 CEDAR STI'.EET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TN(I.D.* PERMIT M <br /> -�� �� �h t S-t -2Z <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> � a �,a�� P_ �-I ,� i < «�.� z�a� P,��,� Sfi �-���� �� ��zo� <br /> TENANT NAME CONTACT FOR PERMR PHONE <br /> /f�v�-�— �'�� �5 ��oue SiaS- I�iz -9z Y� <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.UCENSE p <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> _Electric �Gas_Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Waler heater <br /> _ Kitchen sink 8 disposal � Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> BackOow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Fiaor drain Retrigeratlon <br /> Grease trap �Noodstove <br /> = Roof drains =I Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES 7AJ(CODE IS 3705 <br /> I hereby ceritify that I have read and examined this application and know tha same to be true and correct. All provisions of laws and <br /> ordinaces governing Ihis type o(work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> lo c�ive authority lo violale or cancel lhe provision of any other slate or local law regulaling construcdon or the porformance of <br /> construction.That I am authorized by the owner of lhis property to perform the work for which applicatlon�s made and I comply with the <br /> Stale`Contractors aw .27 RC and 296.20i,WAC. <br /> !z l_/il�(//������dl.�/��/7t� c�� �� L�� <br /> Signa ure—f oF OwnedCont aclorlAuth ed Agent Date <br />