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-� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT', WA 98201 <br /> 425-257-6810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADDRE55 PARCEL TAX I.D.# nPERMIT# <br /> �/ / � T A�e S�' vc�c7 ' �✓t o IJ �UC) --Q <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> O ER ADDRESS CITY2IP pHONE <br /> ,� ��ro fi�jiZ ��l5 'Sf /���- SE �ve �clTw� 9�'l0� y'�ZF�b�F <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> E-MAIL � ��� <br /> NT R A DR S ITYIZ P <br /> CONTR.LICENSF# ��,(J�-Ci(� <br /> USE OF BUILOING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> ��r��o�„� in X z ° �C° �a -ei �3 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIxTURE OR ITEM <br /> Toilel A/C—air handling units <br /> Oathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwaslier Gas range <br /> Clolhes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> Back(low preventer Hea�pump <br /> Urinal Unit heater <br /> Drinking Pountain �oiler <br /> Ploor drain Re(rigeration <br /> Grease lrap Woodstove <br /> Root drains Other <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certity that I have read and examined this applicalion and know the same to he Irue and correcL All provisions ot laws and <br /> ordinances governing ihis type of woik will be complied with whether specifed herein or not.The granting of a permit does not presume <br /> to give aul oriry to violate or cancel Ihe provision of any other state or Iocai law regulating construction or the peAormance of <br /> construc n That I a n authorized by the owner of ihis property to perform Ihe work for which application is made and I compty wilh the <br /> State n�tor� 18.27 RCW and 296200 WAC. <br /> " ��� /� <br /> $i al +nedConlractor/Authorized Ac�ent te �/ <br /> �' <br />