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PL.�MIT APF�ICATIG. J <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 ACCtPTED FROM 8 AM TO 4 PM - DEBIT & CRFDIT CAR�JS ARE NOT ACCEPTED <br /> SITE ADDRES�, / ^ � ,� PARCEL TAX I,D.# P�Ji7# � <br /> l!' � c"�- G./C- I_�i� L C,C�c-a 1C/�,tcyil � / /[� <br /> J C. <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYlZIP PHONE <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> c;- I i <br /> -�I E�r� �Gl.' <br /> CONTRACTOR `�� ,AD�ESS ` � x �_ K ��CITY(ZIP PHONE z � 3 .. <br /> �I�t �-i�•1� c� ��� rt �- / <br /> CONTR.LICENSE# (,il��?ti'ra,C�L.'� 5��� 7-2c%SG� <br /> �i�r���,�< <i�a�u2 � ,� ���; <br /> USE OF BUILD�NG I HEAT SOURCE CONTRACT rRICE OF WORK <br /> 4���/�A�( l']cc T7 f _Electric _.Gas_Olhcr `� z �/ SY? �'" <br /> WORK DESCRIPTION <br /> ;n��:ii� c ��'�i:_�cC , , i�'� 5, ;_�,;�j /��a�,7! <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OF ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilcl A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Waler heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Ranye hood <br /> Sink(service/bar/mop/etcJ Exhaust fan <br /> Backflow prevenler Heal pump <br /> Urinal Unit heater <br /> Drinking Founlain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Rooi drains Other <br /> Ofher <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I herehy ceriti(y lhat I have read and examined this application and know the same to be irue and correcL All provisions of laws and <br /> ordinaces goveming this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authorily to violate or can�el the provision of any olher stale or local law regulaling construction or the per(ormance of <br /> construction.That I am aulhorized by t'ne owner of this property to pedorm lhe work for which application is made and I comply tivith the <br /> Stale Conlra ors La v ?8.27 CW nH 2 8200 WAC. <br /> � �� , r <br /> (;�� l - __--�- <br /> Signature of Owner/Contractor/Authorized Agent Date <br /> � <br />