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PE'� .MIT APPLICATIOh <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 ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ARDRESS ' PARCEL TAX I.D.# PERMIT# <br /> �f J � �' '.C-�c C O O � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS CITY2IP PHONE <br /> ��t�L'� � !? �"�� <br /> TENANTNAME CONTACiFORPERMIT PHONE <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE il ' � <br /> C!�!J/�-���%, <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �'�v _Electric _Gas_Other <br /> WORK DESCRIPTION , <br /> ./%C.� �. �`�---' !U//'".rJG-LJ"�-. <br /> f;�:r.n � .z .��� ^� ;ns�-1��-�-_-'-'�`.' <br /> � l <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lava!ory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kilchen sink&disposal Gas fireplace <br /> Dishwasher G2srange <br /> _ Clothes washer Cblhes dryer <br /> Laundry tray Z Range hood <br /> Sink(service!bar/mop/etc.) Exhaust fan <br /> Back(low prevenler Heat pump <br /> Urinal Unit heater <br /> Drinkinc� Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease Vap Woodslove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TN(CODE IS 3705 <br /> I hereby ceritify lhat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether speci(ied herein or nol The granling of a permit does nol presume <br /> to give authonly lo violate or cancel the provision of any olher stale or local law regulating consWclion or the performance of <br /> construction.That I am aulhorized by the owner o(Ihis property to perform lhe work for which application is made and I comply with lhe <br /> State Contractors Law 18.27 RCW and 29G.200 WAC. <br /> S <br /> (Z � � �, �,, ��, �. . r <br /> ,(t.; ,.,,. �_ � � ,�. �n:t l 01�7I c� <br /> Sign2 i� of OwnedConiractod�ulhonzed P.gent ate' <br />