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t � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857--www.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FP,OM 8 AM TO4 PM ��—/C��-,� <br /> SITE ADDRE33 PARCEL TAX I.D.I! PERMIT M <br /> �?� .5�� �1�O�� - <br /> LEGAL LOT NO. OLOCN TRACT OR SUBDIVISION 4 <br /> DESC. <br /> O R /�DORESS 7Y HONE <br /> v�/ � <br /> TENANTNAM C NTACTFOHPERMIT PHONE ' ��(OS'/� //�S ` <br /> �7/��uJfzt �— ' <br /> Cl%/ef��i�o�`i �co� ' " - � <br /> �o����l�'6�9y�� 3,5�/D/Llo��/i!/f' //��}t�i� 9�'.1�3 <br /> USE OF eUILDING I HEAT SOIIRCE CONTRAC7 PRICE OF WORK <br /> �Eleetfic G75_Other ��/nD0� O D <br /> cv <br /> WORK DESCRIPTION /PPP/�J��/j� '��/��L',� p���� �� �/�� <br /> PLUMBING MECHANICAL <br /> ND. TYPE OF FU(TURE OR I7EM NO. TYPE OF FIXTURE OR IiE]N <br /> _ Toilat AIC—airhandlingunits <br /> _ Balhtub � Forcedairsystems <br /> Lavatory(wash besin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposdl + Gdc fircplace <br /> �ishwasher Gas rl�nge <br /> Clothes washer Clothes dryer <br /> _ Wate�heatet Renge haotl <br /> Sink(sarvicelbar/mop/etc.) Exheusl fan <br /> T Backflowpreventer � Heatpump <br /> Urinal Unit healer <br /> Dnnking Fountain - Boiler <br /> Floor drain Re(riperation <br /> _ Grease Imp � Woodatove <br /> Roof drains -- OMer <br /> O�her <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS.706 <br /> I here6y certily that 1 have read nnd examin2d Ihie applicalion and know the same to be tNe and eortect. All provistons of laws and <br /> ord�nances governing this rype otvrork will be complied with whether specified herein or not.The gr�ntlng of a pem�it does not presume <br /> to give authonty to violatebr cancet the provision of any otner state or lowl law regulatinp construa�on or tne peAortnanca of <br /> conslruction.That I am authorized by the owne�ot this property to perfortn the work fo�whiCh applica�ion is made and I comply with the <br /> St2te Con� ctors Law 18 27 RCW and 2�J8.200 WAC. <br /> �/�/� `2/��JGt� /��/�/� <br /> Signal re o Owner/ContractoNAulhonietl Agent Date � <br />