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RMIT APPLICATIUN <br />CITY OF EVERETT PERMiIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APP�_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� <br />SITE ADDR[SS //�,, �J <br />�/Yjr/�CI f�"d Q/ t!(�( <br />LEGAL LOT NO. BLOCK <br />DESC. '� 00 d <br />PARCEL TAX I.D. # <br />GOSOS�.��nn.,o <br />TRACT , „ _ <br />,-0 7 <br />/� ` C�/ (o <br />VWNtK AUUttt55 1.11TILIY YHVfIC y.as- a6g <br />�rPD 5�,..�s�r �`�D8 w/�E;FF�o 6(v� CvereH- W�4 98a�3 �s2.Z. <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />�'Yr� S�iS�s� YaS=�G� -��Z� <br />CONTRACTOR ADDRESS CITY2IP PHONE <br />CONTR. LICENSE # <br />�%c�J,-�� <br />USE OF BUILDING / HEAT SOURCE I CONTRACT PRICE OF WORK <br />Si�q�P�mr�� ilPSs�P'�'�/ — � — <br />v Eleclric Gas Olher <br />WORKDESCRIPTION �PMr�(�5�. Qk�sf-�� `J�Y�,� /'n,/�'Sr� d cc�/ R(fu��ie�{ J�ir�P <br />da�d. hm wi� h�:ii� S��-�' 4.GovC' <br />—O°mo{�(�. �2n.e(.s!-ar� �iSf."`J Fn'/c'SP��tpw l.ncl S/b�.�a.'.� o;�,/•• oh�.SS'� 1ST�' <br />s�br a(,o. S � � <br />PLUMBING MECHANICAL <br />NO. I TYPE OF FI%TURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub . <br />Lavalory (wash basin) - <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Ciothes washer <br />Water healcr <br />Sink (sarvice/badmop/olc.) <br />Backflow prevenler <br />Urinal <br />Drinkir.c� Fountain <br />Floor drain <br />Greaso trap <br />Roof drains <br />Othor <br />A/C — air handling units <br />Forced alr systems <br />Gas piping <br />Wator heater <br />Gas fireplace <br />Gas range <br />'� Clothes dryor <br />/ Range hood <br />' S 1 Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Olhor ��hq�_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lhal I have read and examined this application and know lhe same lo bo true and correcl. All provisions of laws and <br />ordinaces c�oveming this lypo of work will be complied with whelher speci(ied herein or not. The granting of a permil does not presume <br />to give aulhority lo violalo or cancel lhe provision of any olher slale or local law regulaling conslruclion or lhe peAormance of <br />conslruction. Thal I am aulhorized by the owner o( this property to porform Ihe work for which applicali„n is made and I comply with the <br />State Coniracteeslvew-t�.2ZRCW and 2�J�.200 WAC. <br />�v <br />