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PERMIT APPLICATION <br /> CITY �F EVERETT PERMIT SERVICES <br /> 3;:00 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25:'-8810— FAX 425-257-8857 —www.everettwa.org <br /> APPLICATI'v�lS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,SITE ADDRESS � —, PARCEL TAX I.D.p ' PERMIT tF <br /> y�" �/i�, ��''=^ �'r'�-�= l�C I I - Q9 I <br /> LCGA LOT NO. BLOCK TRACT OR SUODIVIS�ON M <br /> ESC. <br /> OWNER ADDRESS CITYIZIP PHONE/�5 3�3;;�,�1�I � <br /> 1 � � <br /> /—•;i�,vi< � /j��:c��i� /fj�fNr U/!� L�/��/o�=�j� G%��/% 94.��'3 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E•MAIL <br /> NTRA � A DRE IZI H E <br /> ��✓�r/�,t�,v /—i.L�-pl«� �'//v,f' �^�S'�nf7sZU9?' ��.f'<'%% �%�N�'/ <br /> CONTR.LICENSE# L/ //���C!'//z <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �=Eleclric _G�s_O�her <br /> WORK DtSCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE Of FIXTUftE OR ITEM NO, TYPE OF FIXTURE OR ITEM <br /> Toilet _ NC—air handling units <br /> k3athtub _ Forced air systams <br /> Lavalory(wash basin) _ Gas piping <br /> Shower _ Waler heater <br /> Kitchen sink&disposal _ Gas freplace <br /> Dishwasher _ Gas range <br /> Glothes washer _ Clothes dryer <br /> Water healer _ R�nge hood <br /> Sink (serviceNar/mopietc.) __ Exhausl fan <br /> Backflow preventer _ liea�pump <br /> Urinal _ Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Re(rigeralion <br /> Grease trap _ Woodstove <br /> Rool drains Other <br /> Olher — — <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3705 <br /> I hereby certify�hat I have read and examined this applicalion and know the same to be irue and correcL All provisions of laws and <br /> ordinances goveming this rype o(�vork will be complied with whether specified herein or not. The grantin�ot a permit does not presume <br /> i to give authoriry lo violate or cancel the provision of any olher slale or local law regulating constraction or lhe perlormance o( <br /> Iconslruclion. Tha� I am authorized by the owner of this property to peHonn ihe work forwhich applica�ion is made and I wmply with the <br /> I Stale Coniraclors Law 1827 RCW anu 29G.200\NAC. <br /> SignaWre of OwnedConlrador/Aulhorized Agent rl a��'O <br /> �___ __. .—._ . . . _ . _. . . - --- ----._--- --- -- ------- <br />