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PERMIT APPLICATION <br />ParR�Ene*rPeEexiaae� ses <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 -FAX 425-257-8857 - www.everettwa.Drg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-7 <br />SITE ADDRESS �32 / <br />PARCEL TAX I.D. p <br />PERMIT N <br />LEGAEU LOT N0. BLOCK <br />TRACTOR SUBDIVISION <br />V <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />d <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />EMAIL <br />CONTRAC: <br />' !'N�i OG� 14-1J� sN1�'11S 3c7J2ci <br />CONTR. LICENSE N <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />— Electric Gas Other <br />n0 <br />I <br />WORK DESCRIPTION <br />RED �l /}I� <br />l f=UiU'� �INIC 1'�L <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />� <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/n,op/etc.) <br />Exhaust fan <br />_ <br />Buckllow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Imo..... <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />— <br />Other N•/FIr�--" <br />_L <br />� n �t 1' 1'•A_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I here"), certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />�. <br />III <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting or a permit does not presume <br />_. <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and 1 comply with the <br />State Contr t rs L%°178 27 RC d 6.200 WAC. <br />-�. <br />Signature of Owner/GontraclorlAulhonzed gent D.ae <br />