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,- <br /> ptRMIT APPLICATIUN <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 /> PARCEL TAX I.D.8 PERMIT# <br /> SITE ADDRESS �p� '�_ <br /> i�1� � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION M <br /> DESC. CITY2IP PHONE <br /> ADDRESS <br /> OWNER <br /> \�Z�q �Zv�.,�C� •r t.'Vv'a.c�P� 9b1AZ u'LS'-Z�1-I 1 1. <br /> �� <br /> I CONTACTFORPERMIT PHONE <br /> TENANTNAME <br /> �n�Q,�(„'CNL E•MAIL <br /> TRAC O A OR � r � ��.b�yJa �A �Z�O <br /> `'�ZL/ 7��C� <br /> 1Z`/►L�� ,v�.C-- 4ZS •3Zu -oZSL <br /> CONTR.LICENSE A p��,���q��-�J� <br /> t� <br /> USE OF BUILDING <br /> HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleclric �Gas_Othcr <br /> 5r2 - <br /> WORK DESCRIPTION �7 <br /> �ITf.�tE7�1 f-`�-�u0�.'-1. <br /> MECHANICAL <br /> PLUMBING <br /> NO. TYPE OF FIXTURE OR ITEM <br /> NO. TYPE OF FIXTURE OR ITEM <br /> NC-air handling units <br /> Toilel Forced air syslems <br /> Bathlub Gas piping <br /> Lavalory(wash basin) Water heater <br /> Shower Gas(ireplace <br /> _�_ Kitchen sink 8 disposal Gas range <br /> Dishwasher Cblhes dryer <br /> Clothes washer Ranc�e hood <br /> Waler healer Exhausl(an <br /> Sink(service/barlmop/etc.) Heal pump <br /> Backflow prevenler Unit heater <br /> Urinal Boiler <br /> Drinkinc� Fountain Refrigeration <br /> Floor drain Woodstovo <br /> Grease trap Olher�_ <br /> Roof drains — _�_ <br /> 011ier�— <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriti(y lhat I have read and examined this application and know the same to be lrue and correct. All provisions oi laws and <br /> t glive autl�io ity to vio1late oP cancelr lie'prov's on�4ol any olther state or�loclall aw regu a6ng`consl uclion o�the peAormance o(Presume <br /> construr.tion.That I am authorized by the o�vncr ot lhis property to perform the work for which application is made and I comply with the <br /> Slale CoMractors Law 18.27 RCW and 296.200 WAC. <br /> _�^�—� �O� <br /> Signature o(OwnedConlraclodAulhonzed Agent <br /> Date <br />