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P�r�MIT APPLICATIG�J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org � <br /> ���3 � o� 9 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS A E NOT ACCEPTED <br /> SITE ADDRESS . PARCEL TAX I.D.# PERMIT# <br /> 31oS j C�xe, (�j� �' �.Y3/ <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. � <br /> OWNER ADORESS CITY2IP PNONE <br /> F� � 31oS i��� f�� 9d�1 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACI'OR s ' � ADDRESS !� �00 /„�,�A_ CITY2IP PHONE�aS'3JS "d7 <br /> ! �rms� <br /> CONTR.LICENSE#s I DCD y� 0��OT 3//�/O�/, � �i�1� <br /> �- �' 9�s�7S. <br /> L'SE OF BUILDING I �T SOURCE I CONTRACT PRICE OF WORK <br /> S `'''�`��'G�"�d- � - - I� 7b�� <br /> ✓Electric Gas Olher <br /> WORK DESCRIPTION <br /> �i/�L LCl'/Ll�f/+(�� �% .L%1�L�� E%S�%i%L'KTir*i`/�.l�^^""""!/� /���%fi�%pQiG�..I <br /> PLUMBING MECHANICAL <br /> NO. 7ypE OF FIXTURE OR ITEM NO. NPE OF FIXTURE OR ITEM <br /> Toilet I A/C—airhandlingu <br /> = Bathtub�j Forcedairsystems� <br /> Lavalor��(vash basin) Gas piping <br /> Shower Water heate� <br /> Kitchen sink 8 disposal � Gas fireplace <br /> � ishwasher1� as range <br /> _ Clothes washer j� Clothes dryer � <br /> _ Laundry tray �L ✓ Range hood U <br /> _ Sink(service/badmop/etc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> Urinal — <br /> — Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> ,_ Grease irap Woodstove <br /> _ Roof drains Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS J105 <br /> I hereby ceritify thal I have read and examined this application and know the same to be true and correcL All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The grenling of a permit does nol presume <br /> ' to give authonty to violale or cancel the provision o(any other state or local law regulating construction or the pertormance of <br /> conslruction.That I am authorized by the owner o(this property to periorm the work for which application is made 2nd I comply wilh the <br /> Slate Contractors Law 18.27 RCW and 296.200 WAC. <br /> ��� � ��� �� �� � <br /> Signature of Owner/Contractor/Authonz gent p� � <br /> t <br />