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{� <br /> PERMIT APPLICATION <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 g—lg— I� <br /> SRE ADDRE PARCEL TAX I.D.t PERMIT�i <br /> � 'I.�• ��c�,�r 00 1�a1.ti 1 0 ' �S- tx� 5 <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION/ <br /> DESC. <br /> rai <br /> '�e.J fow� U.0 ISt'� ��v�;��co �� . 'Mu ; U $1,1� <br /> �N ACT R PE R �j� � <br /> An 1 - �� <br /> � � 1v\G�(C Y�{, I ��n �1 e.uN� � <br /> � \ �•c� �q�� ���r�� �"Q81,o `�,S-Nha-�1� <br /> R.L NSE f `Pv <br /> SE OF BUILDING HEAT SOURCE CONTRA�ICE OF WORK <br /> ���,��,p.�j, _Electric _Ges_C1her � ��q � <br /> WORK DESCRIPTION <br /> a �� s.�k.s <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF Fl%TUHE OR REM N0. TIPE OF FIXTURE OR REM <br /> Toilet _ A/C—air handling units <br /> Bathtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Sliower _ Wffierheater <br /> Kitchen sink 8 disposal _ Gas tireplace <br /> Dishwasher _ Gas range <br /> Clothes washer _ Clothes dryer <br /> Water hoater _ Range hood <br /> Sink(service/badmop/etc.) _ Ezhaust fan <br /> Backtlow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floor drain _ Retrigeration <br /> Grease trap _ Woodstove <br /> Rool drains _ Olher <br /> Olher — <br /> CITY OF EVERETT LOCAL SALES TAI(CODE IS 3t05 <br /> I hereby ceritity that I have read and examined this application and know the same to be Irue and coned. All provisions of lawc and <br /> ordinaces governing this type ot work will be complied with whether specified herein or nat.The prenting oi a pertnit does nol prewme <br /> to give authority to vioiate or cancel the provision ol any other stale or local law regulating consinicOon or the pe�iortnance of <br /> constru ion.That 1 am authorized by the owner ol this property to pertortn Ihe work tor which applicalbn is made and I comply wiM tl�e <br /> Stat ontractors 18.27 RC and 296200 WAC. <br /> �� � �� �� <br /> ignature of wned oNr .r/ ihori ed Agent ate �a <br />