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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—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL 7AX I.D./ PERMIT N <br /> 32 G `G ifJc 2�t�N Avc �o - o <br /> LEGAL LOT NO. BLOCK 7RACT OR SUBDIVISION I <br /> DESC. <br /> OWNER ADDRESS CITY2IP P1{ONE <br /> �skl�e� Crr�h� 320$ N�•�k Av ��e�cit 9�Z <br /> TENANTNAME w' �Z� Z5a��3v <br /> ICONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> BateK �oL���'"`1 IM- Po. �,� g2�3c ►cenr�,K `a�oz$ -}2s -r;vc z�fi <br /> CONTR.UCENSE N <br /> bc�lzy�i q 3 2 4 z <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �S`N � I ,_Eledric _Gas_Other � � R S 5' �— <br /> WORK DESCRIPTION <br /> IZw� r�pl4w n,c�F ���4 � LcKe nv s�w�tia.,y <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ Toilet AIC–air handlin units <br /> _ Bathtub Forcedairsyslems <br /> _ Lavatory(wash basin) _ Gas piping <br /> _ Shower _ Water heater <br /> _ Kitchen sir,,c 8 disposal _ Gas fireplace <br /> _ Dishwasher ,_ Gasrange <br /> _ Clothes washer Clothes dryer <br /> _ Waterheater _ Rangehood <br /> _ Sink(servicelbarlmop/etc.) Exhaust han <br /> _ BackFlow preventer Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floordrain _ Refrigeration <br /> _ Grease trap _ Woodstove <br /> _ Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 7705 <br /> I hereby ceRify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances governing this type of work will be complied with whether specified herein or not.The granting of a pertnit tloes not presume <br /> to give authoriry to violate or cancel the provision of any other state or local Iaw regulating construction or the perfortnance of <br /> construction. hat I am authorized by the owner of this property to perfortn the work for which application is made and i comply with the <br /> State Co rs'� 18.27 RCW and 296.200 WAC. <br /> �' � ` � �����D <br /> Sgnature of Owne/Contractor/Authonzed Agent Dat <br />