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I--- <br /> F�RMIT APPLICATIuN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _, a 'a-��� <br /> SITE ADDRESS PARCEL TAX I.D.# PE IT# <br /> 25U�' ' - D <br /> LEGA LOT NO. �BLOCK TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADORESS CITYIZIP PHON[ <br /> � 2 � � ` 2Ub.���z.z� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> (�(��y_�t A. IIJY M � Y 1 2�IO�7 IGS-�V�rU2.��� /bZOS E•MAIL 7L^S '�7' S`� <br /> �6ATRA � � <br /> CONTR.LICENSE# IJ� /�, I K /" G _J I U� � � U/ //�� <br /> USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �Eleclric Gas_Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 2 Toilel AIC—air handling unils <br /> 2 Balhtub I'orced air systems <br /> �. Lava�ory (wash baein) Gas piping <br /> � Shower `Nater heater <br /> � Kitchen sink&disposal _ Gas fireplace <br /> i Dishwasher Gas range <br /> _L C�olhes washer _ Clothes dryer <br /> 1,_ Water heater _ Range hood <br /> Sink(servicelbarlmop/etc.) Lxhaust fan <br /> Backflow preventer � Heat pump <br /> Urinal Unit healer <br /> Drinking f-ountain _ E3oiler <br /> Floor drain Retrigeration <br /> Grease trap Woods�ove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby certify�hat I have read and examined ihis application and know the same lo be true and correct. All provisions ol laws and <br /> ordinances governing ihis type o1 work will be complied with whelher specified herein or not. The granting ol a permit does not presume <br /> to give authority to violate or cancel the provision of any olher state or local law regulating wnsiruction or the peAormance ot <br /> iconstruction. That 1 am authonzed by lhe owner o(this property to periorm the work for which application is made and I comply with the <br /> I State Cl ntiac�s�avy 18,27 RC�d 296200 WAC. <br /> i <br /> � /i �-�� �, __ <br /> SigoatT 1 OwnedCo tra todAutl ori d Agent Da�e <br />