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a .RMIT APPLICATI� ,� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _al�`IO <br /> 31TE ADDRESS PARCEL TAX I.D.A PERMIT IF <br /> 10 ' �Gi+ 8zo1 <br /> LEGA LOT NO. BLOCK TRACT OR 9UBDMSION M <br /> DESC. <br /> OWNER ADDRE39 CITY/ZIP PMONE <br /> P�.c�Lt Sovnd kiane� C:e.,ieC �Qii Paci�:c. flu� ��.�eft, WA a`'Zol <br /> TENANT NAME CONTACT FOR PERMIT-r� Sm�{� PHONE <br /> JV <br /> P Lt So� ki�ne Ce�.�< <w e��a�o ��/-�SUoZ <br /> Rigti+�y Piw�b�n� 3 I{��}i� 4l-A Sw�set Park o�c $�roc,�olky �3t�o) �SS- z(oto5 <br /> CONTR.LICENSE R ' � �828y <br /> R�c+NT�aP o��r�s <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> p����,Q, $�� I _Eledric ,�Gas_Olher � �� � Oo <br /> WORK DESCRIPTION <br /> Zns�at� S NvRc, R,o�op �,�,�ts w��H. gae '; d�+;r� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITB�) <br /> Toilet � A/C—air handli�g unils <br /> Bathtub � Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer _ Ctothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mopletc.) � Exhaust fan <br /> Backflow preventer _ _� Heal pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floor drain _ Rehigeretion <br /> Grease trap _ Woodstove <br /> Root drains _. Other <br /> � Other _ — <br /> — _ _ I . <br /> CITY OF EVERETT LOCAL SALES TAX C06E IS J706 <br /> I hereby certify lhal I have read and examined ihis application and know the same to be true and correct. All provisions of lews and <br /> ordinances governing this type of work will be complied with whether specified herein or not.The granting of a pertnil dces not presume <br /> to give authority to vidate or cancel the provision oi any olher state or local law regulating construction or the perfortnance of <br /> construc+�on.That I am =::!horized by the owner of this propeRy to perform the work for which application ia made and I compty with the <br /> Slate Contractors Law 18. 9�C nd 296.200 WAC. <br /> �� ��c ,�r10 <br /> Signature o(UwnedConiractodAutho ed Agenl Date <br /> �Iz <br />