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P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-6810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � � ( 7 � /I} <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT if <br /> 3 7/ �, -02� - <br /> LEGA LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER AD�RESS CITY2IP PHONE <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> H <br /> CONTR.LICENSE#��" � ��� .�� <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> _Electric _,Gas_Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Dalhtub Forced air systems • <br /> Lavalory(wash basin) _ Gas piping � � <br /> = Shower � / aterheate��L � C� <br /> Ki�chen sink 8 disposal �� Gas fireplace <br /> Dishwasher � _ Gasrange <br /> = Gothes washer � _ Clothes dryer <br /> Waler heater � _ Range hood <br /> Sink (service/barhnop/elcJ _ Exhaust fan <br /> �ackflow preventer C� _ Heat pump <br /> Urinal Unit hea�er <br /> Drinking Foun�ain _ Boiler <br /> Floor drain Reirigeration <br /> Grease lrap _ Woodstove <br /> Roof drains Olher _ <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certify lhal I have read and examined this application and know Ihe same to be true and correcL All provisions of laws and <br /> ordinances goveminc�Ihis type of work will be complied with whelher specified herein or no�. The granling of a pertni�does nol presume <br /> to give authority lo violate or c2ncel Ihe provision of any other slale or local law regulating construction or the pertormance ot <br /> conslruction. Thal I am aulhorized by the owner of lhis property to peAorm ihe work for which applicalion is made and I comply with lhe <br /> Slate Conlractors Law 1827 RCW and 29�200 WAC. <br /> i �• . <br /> SignaWre o(OwnedContractor/Authorized Agen� — Date <br />