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PL� .1MiiT APPLIC4TI4. � <br /> CITY OF EY�ERETT 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 (� '-'� —�9 <br /> -�• PARCEL TAX I.D.q PERMIT# �j( <br /> SITEAr,DDRt•�b ,/ ��OI _-Dw <br /> � { l �Z�� SO,'.(,llC'� A�/ � Yl <br /> LEGq— LOT NO. BLOCK TRACT OR SUBDIVISION k <br /> DESC. <br /> OWNER ADURESS ��TM�Z�P �($P207 <br /> \,Jr.�� C� 5 w ti �� N�T IF' S ��Au2 Eve�e-(-t (yz3�31 �-S,�' <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> N�� � �Nzs" �773-I <br /> 6'ctS f�� �l,In(� ��2C �LA4'Ni: jNFU�' /""�n-7i�<AhAVC�St L��]/1 WUCo� <br /> CONTR.LICENSEM ��AS PIPt�l9s� �� WA �s�� � <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � 3 ��o `= <br /> Elechic ,�Gas_Olher i <br /> WORK^ESCRIPTION <br /> G'cs �=,���,,r-cP �ns� ��l � ��s Pir'e �ns ,�r�l <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet _ A/C-airhandlingunits <br /> Bathtub Forced air syslems <br /> Lavatory(wash basin) �( Gas piping <br /> Shower _ W�ter heater <br /> Ki�chen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasiange <br /> Clothes washer _ Cbthes dryer <br /> Water heater _ Range hood <br /> Sink (servicelbar/mop/etc.) _ Exhaust fan <br /> Backflow prevenler _ Heal pump <br /> Urinal _ Unit heater <br /> Drinking foun�ain _ f3oiler <br /> 1=loordrain _ Refrigeration <br /> Grease trap _ Woodstove <br /> tioo(drains Other <br /> Other _� 6��� �cr�6weC� <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> I hereby certify lhal�have read and examined lhis applica�ion and know Ihe same to be true and correct. All provisions o(�aws and <br /> ordinances goveming ihis type of work will be complied with whether specifed herein or not.The granting of a permit does nol presume <br /> to give aulhority to violate or cancel Ihe provision of any other slate or local law reryuiating wnsirudion or lhe performance of <br /> ccnstruclion. That I am authorized by the owner of this property to pertorm the work fa which application is made and I comply with the <br /> State Contraclors Law'Ig„27-R6W�and296.20QW�C. <br /> . j� ��' `-� � -� <br /> - "-�---'�—�---�� !] �?J�(7 <br /> Signalure of Atv9ad n raclodAuthor¢e�lge <br />