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r � -- -- <br /> PE�tMIT APPLICATIOIv � <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ^ �v�' <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org I��J <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.N PER IT/ <br /> lo I 3S Mcr ic� ,�,� ���. �C._�`lE�`i c,cc��,�ioc, �S-O/ <br /> LEGA LOT NO.� BLOCK TRA T �� -Z�� <br /> DESC. � <br /> OWNER AD SS CI lZIP PMONE <br /> �U / ��. <br /> S`1��� ��I��, / /�,1����p �a+s�r I��� a� (1�W.�, I-��� ��q8?�5 �-'��i 3�s� <br /> TENANTNAME ( CONTACTFORPERMIT PHONE <br /> CONTRACTOR�u��.�C+�S, ��, • ��a Fi$ x .7��.j CITY2IP � PHONE <br /> ' �as <br /> �-o U <br /> CONTR.ULENSEt�I�,�11I�S �1u�. I I (� I,,�,�('L�� � �j _ <br /> -� \'1- W -IW a_�-3��� <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �S _Electric 1� Gas_Other �-� (�i — �bU <br /> S I{� �<�^ <br /> WORK DESCRIPTION ' ' LIO� 7 — <br /> �;I�t�,1 ��SCC� 29/Z / <br /> �ZU �/��-�C.��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet A/C–air handling units <br /> %. >' Bathtub � Forced air syslems <br /> � Lavatory(wash basin) t�-� Gas piping <br /> /�„_ Shower � Water heater <br /> � Kilchen sink 8 disposal I Gas lireplace <br /> � Dishwashcr � Gasrange <br /> � Clothes washer I Clothes dryer <br /> _ Laundry Iray � Ran�e hood <br /> Sink(service/bar/mop/etc.) S Exhausl fan <br /> Backflow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease Irap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and cortect. All provisions o(laws and <br /> ordinaces governing this typa ol work will be complied with whelher specified herein or not.The granting o(a permil does nol presume <br /> lo give aulhority lo violate or cancel the provision ol any other state or local law regulating construction or lhe periormance of <br /> construclion.Thal I am aulhorized by lhe owner of this property lo perfortn the work for which application is made and I comply with lho <br /> Slale Contractors Law 18.27 RCW and 296.200 WAC. <br /> � ��� �-�s-as �1 <br /> Signature ol OwnedContractodAulhonzed Agent Date Z <br /> �LFz9z�'� z� <br />