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� ` — <br /> PERMIT APPLICATION <br /> CITY OF EVFRETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETr, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —w�rnv.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS �1� PARCEL TAX I.D.fl P RMIT N <br /> qo6 � k �:� �� � <br /> 0 ;3 <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION� <br /> DESC. p <br /> UWN� ADORESS CITYIZIP PHONE �?,f' 3 Yl� <br /> /'/'aN �' D�a�wi� �,5•32 �ock��/�r r}v �Jeir7Y 5��.20 � _ <br /> TENANi NAME CONTACT FOR PERMIT PHONE�}ZS ���'7ZZ <br /> �d ' I � {3reeS Ce+� �aw� n4 E-MAIL <br /> CONTRACTOR ADDRESS CITYIZIP PHO E <br /> CONTR. LICENSE# <br /> D�leS i pC�IgAv <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> 1�C�S 1 CI�Y� C P _Eleclric �Gas_Other <br /> WORKDESCRIPTION .uv(,�,-}�r'- -f.2PIPe �--A�� �,Uu,Sher b0�'es; <br /> �L��17k YL� LV(ill �l�l�ll� lL�ci�-L <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> !6. Toilet _ AIC–airhandlingunits <br /> f � 6alhlub Forced air systems <br /> � Lavalory(wash basin) _ Gas piping <br /> � Shower � Water h�ater <br /> � Kilchen sink 8 disposal Gas freplace <br /> / Dishwasher Gas renge <br /> � Clolhes washer Clothes dryer <br /> � Water healer Range hood <br /> Sink(service/badmop/etc.) [xhdusl fan <br /> � BackOow preventer Heal pump <br /> Urinal _ �Unil healer <br /> Drinking Fountain _ ',[3oiler <br /> Floor drain _ Refrigeration <br /> Giease trap _ Woodslove <br /> Roof drains _ Other <br /> Olher — – <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> I h�reby certify that I have read and examined this application and know lhe same to be true and corred. All provisions of lows and <br /> ordinances yoverning Ihis type of�vork�vill be complied�vith whether specified'ierein ur noL The granting o(a Fermit does r�t presume <br /> lo give aulhonty to violate or cancel Ih�provision of any olher slale or Ic,cal la�ro regulating conslruction or the periormance of <br /> conslruclion. That I n authorized by , :owner of this property lo pertorm the vork for�vhich application is made and I comp�y v+ilh tha <br /> Sta�e Conlra rs 8.27 RCW and 29�.200 WAC. <br /> , Ib� i5• a�� � o I <br /> SignaWr of �.�/C itractodAulhorized Flgent Dale <br /> I <br />