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� PE,cMiT APPLICATIO'�� <br /> C1i Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS AR� ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D. # PE MIT# <br /> 1N�6 C�/�_FS ,4��E - V� �I b�' � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE (�ZS <br /> �cor�` y�N S /y,�6 c���fS �4i�E - .�Vi�ir 9�Zdr a -3�/3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �jlo7J`�Ei� yz�-Zb g- 7�03 (Ce//) <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> ��,E-0�N�"� <br /> CONTR.LICENSE# �� r / <br /> ,5;4 nvF R.S �JY� - <br /> USE OF E3UILDING .EkIST�yG HEAT SOURCE CONTRACT PRICE OF WORK <br /> SF�� �Electric _Gas_Other � /U J¢ <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. I TYPE OF FIXTURE OR ITEM NO. TYPE OF FDCTURE OR ITEM <br /> Toilet PJC—air handling units <br /> _ Bathtub � Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower _ \Vater heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer Clothes dryer <br /> Laundry iray _ Range hcod <br /> Sink (service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _, Heal pump <br /> �rinal _ Unit heater <br /> � Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> I Grease lrap _ �Noodstove <br /> Roof drains _ Olher <br /> ; _ Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3'105 <br /> I hereby ceritify that I have read and examined this application and kno�v the saTe to be true and correct. All provisions of laws and <br /> ordinaces goveming this rype of work�vill be complied with whether specified herein or not.The granting of a permit does not presume <br /> ;o give authonty to violate or cancel lhe provision of any other state er Iccal iaw regulating conslruction or the performance of <br /> consiruction.That I am au' nzed by the owner uf this property to perform ihe work for which 2pplication is made and I comply with the <br /> State nt c;ors L v 1 .�RCW and 256?00 WAC. <br /> � �a � ��r�3 S-7� '�`f <br /> atQre ot nerl ntractonAuthonzed Agent Oate � <br /> + I <br />