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^.dF;s. <br /> i�� i <br /> .y'.TT Y _' _ <br /> .fji <br />�°� P�RIVIIT APPLICATION <br />� � CITY OF EVERETT PERMIT SERVICES <br />� ``"� 3200 CEDAR STREET, EVERETT, WA 98201 <br />�:;� � <br />, +�,< i 425-257-8810- FAX 425-257-8857 -www.Pverettwa.org <br />� � .. � <br /> i� <br /> ' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i�� , SITE ADDRESS PARCEL TAX I.D.# P MIT# <br />,=�.,�.„1 .� �} c-�1� �� <br /> I <br /> ~�' LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 CITY/ZIP PHONE <br /> i , <br /> ,. �,� <br /> �r T,., � ?r;r - o- �u <br /> l � � = > � u <br /> TENANTNAME CONTACTFORPERMIT I PHONE <br /> `\�YIT ;�_.V �I � 1GICz., ���rl�1 �(�.�"�fi�?o� <br /> CONTR CTOR � ADDRESS� CITY21P �PF�ONE <br /> i"i �-�//� � <br /> CONTR. LICENSE# �� �,(��' C� .^-� /�/ (� l� ��- <br /> I <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ,K�(��, �r��� �Electric •�Gas_Other 1`� �b <br /> 1l <br /> WORK DESCRIPTION <br /> lL � /`^' `'���� <br /> ��1� ��� �,✓�y�� c-- ��.� � � .� �-�ti � <br /> , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. 1YPE OF FIXTURE OR ITEM <br /> w,� Toilet __ A/C-airhandlingunils I <br />�� � . ' _ Balhtub _ Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br />�`�`'` Shower Walerhealer <br />� ,.., ,;;:'; — <br />�;�:,, : Kitchen sink 8 disposal Gas fireplace <br /> L7ishwasher Gas range <br /> _ Clothes washer Clothes dryer � <br /> _ Laundry lray ' Range hood ! ,qp� � <br /> Sink(service/bar/mop/elc.) Exhaust fan /� <br /> �: _ Back(low prevenlar _ Healpo.ip <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease lrap Woodslove <br /> Roof drains Olher YP�(i((1'�'� C�C�� ���C� <br /> I _ Other�)1�V,t�( C`V� ��y'',t11`' _ —� <br /> — -- — I <br /> CITY OF EVERETT LOCAL SALES 1'A7(CODE IS 3105 I <br /> I hereby cerilify that I have read and examined lhis application and know the same to be true and correcl. All provisions of Iaws and ! <br /> ordinaces goveming lhis type of work will be complied with whelher speci(ied herein or noL The granting of a permil does not presume ! <br /> to give aulhor' lo violate or cancel the provision of any other state or local law regulaling consWction or the performance of <br /> constructio That I am authorized b the owner of lhis property to periorm the work(or which application is made and I comply with the <br /> Stale Cog raF(or�Law 1t3;27lfZCV�I d 296.200 WAC. <br /> l� _ ,Y ') <br /> Signatu vf. wnedC ntreclor/ ulhonzed Agenl a �J� <br /> /✓ <br /> - . ,.<.._ . n_. .. _... <br /> �` . ,f� x . <br /> -. - .-.�.aF-..w :�.`..�.al�+lor......�wwa�wnta�:hmf�¢tw� ' �- � .. 11 . ... L' <br />