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PEt2MIT APPLiCATIOnI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREtT, EVERETT,WA 98201 <br /> ���� 425-257-8810— FAX 425-257-8857—vdww.everettwa.c:rg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL 1?J(I.D.# PERMIT# <br /> � �� c go s�s-�-c&' <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYlZIP PFIUNE <br /> r <br /> � � <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleclric Gas Olher <br /> WORK DESCRIPTION <br /> /� ��,�-� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> Toilet . A/C—air handling unils <br /> Balhtub � 'brced air systems <br /> Lavatory(wash basin) vas piping <br /> Shower Water heater <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Cbthes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backtlow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> F(oor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby ccriti(y thal I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces governing this;�pe of work will be complied with whether specified herein or not.The granting of a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other state or tocal law regulating construcGon or the performance of <br /> construction.That 1 am authorized by the owner of this property to perfortn the work for which applicaUon is made and I comply with the <br /> State Conlractors Law 18.i7 RCW and 296.200 WAC. <br /> SignaWre of OwnedContracrodAuthorized Agent Date <br />