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�- -- <br /> j PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES � <br /> I 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 , <br /> SITE ADDRESS PARCEL TAX I.D.# � 'MIT# � <br /> � " Z� y/ 5� SfY<<"r (JDS � ? 10I CDI ]O ( _� sI U - (o <br /> LEGAL LOTNO. BLOCK TRACT �� <br /> DESC. <br /> OWNER qDDRE55 CITYIZIP PHONE � <br /> (� r�sf- Lv �fclz to�5� ��.�. sfrrt�t' £�•:.��/F [.if- 7�(zo 1 �'� <br /> TENANT NAME CONTACT FOR PERMIT PHONE ' <br /> LR _Cce�-I�i N1 rx��o✓ /'.,SfvJ�� St�u� fLo��1, �/1S`- 77L-FfS�3S� I <br /> CONTRACTOR Bt%/ry NLcti C'(i AODRESS CITYIZIP PHONE <br /> � 7 `/t�c <br /> l�Ar,f�So,.� �D fu:..�ld- w4 Y1J- 77.�..��i-�S-i <br /> CONTR.LICENSE# l.��Z C j � <br /> �t,i ry�/Ci. J7[ M �� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK I <br /> /'PS�qu� g�,'r _Electric _Gas_Otner �i � pp� G� I <br /> WORK DESCRIPTION <br /> iv;;�lsc� Cz� S;�l� �'hcz�.v /. �� �a-5� .,,�f- s��N 5 I <br /> PLUMBING MECHANICAL <br /> � <br /> NO. TYP[OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM � <br /> _ Toilet N'C—air handling units <br /> BathWb Forced air systems ' <br />����'�:`��"�' _ Lavatory(wash basin) Gas piping � <br /> �� . _ Shower Water heater I <br />� _ � Kitchen sink 8 disposal Gas fireplace � <br /> y' <br />:,��¢;�;' _ Dishwasher Gas range I <br />��� -•�� _ Clothes washer Clothes dryer I <br /> _ _ Laundry tray Range hood <br /> Sink(serviceNar/mop/etc,) Exhaust fan � <br /> Backflow preventer Heat pump � <br /> _ Urinal Unit heater ; <br /> _ Drinking Fountain Boiler ' <br /> _ Floor drain Refrigeration li <br /> Grease trap Woodstove � <br /> _ Roof drains _ Other I <br /> Other <br />; : '-. I� _ = I � <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> II hereby ceritify that I have read and examined this application and know the same to b�true and correct All provisions of laws and '� <br /> Iordinaces governing this type ot�vork will be complied with whether specifed herein or not The granting of z permit does not presume � <br /> to give authority to violate or cancel the provision of any other state or local law reyulating construction or the performance of <br /> conshuction. That I am a orized by th er of this roperty to per(orm the work for which application is made and I wmpty with the I, <br /> State Contractors Law 27 RC 62 , <br /> Signatu neUConire tor/Authorized Agen Date <br /> j,. <br />