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�� PEKMIT APPLIC�TIOfV '� <br /> CITY OF EVERETT P�RMIT SERVlCES ; <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' <br /> 425-257-8810— FA.`C 425-257-8857—www.everettwa.ora �Q.1/� � � <br /> l� <br /> IAPPLICATIONS ARE ACCEPTED FROM 8 FM TO 4 PM - DEBIT & CREDIT. CARDS ARE NOT ACCEPTE ll <br /> SITE ADDRESS PARCEL TAX I.D. # PE MIT# <br /> �� ic ��� ��� '� 3tz 30�f' 0�-7 ��0 �_ ' <br /> LEGAL LOTNO. BLOCIC TRACT <br /> DESC. 3 (� <br /> OWNER ApGRESS CITYI'LIP PHONE <br /> :i i ,� �'�� .: �i «6 0 / <br /> /� ¢D / �:� f��u,����� � !1,�.:�� %%(, ,.,� G,,s .�J 1;(� <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> CONTRACTOR��. �:._. �t'��,�� �� ADDRESS CITY/ZIP PHONE <br /> � �✓vj�,� Yi� C�f. 4,-,� , r�:. .. • , . � <br /> CONTR.LICENSE# �, � � � • � <br /> ���kc� * o �zcd �` ' J ' s � � .3 ;�� r�,� - <br /> USE OF BUILUING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �„i;�! ����,. ,/ Eleciric X Gas Olher � � i', v � � <br /> � <br /> > <br /> WORK DESCRIPTION � <br /> � _:�':.u-i�.�, � �� �.,) �_. � J-� l c � � 1.��. lE':� <br /> l�s�y / <br /> � C.' — I <br /> PLUMBING MECHANIC.4L <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilet A/C-air handling units <br /> � Bathlub 7 Forced air systems � <br /> � Lavatory(��ash basin) � Gas piping <br /> y_ Shower �_ Water hea[er i <br /> � Kitchen sink 8 disposal / Gas fireplace <br /> / Dishwasher � Gas range i <br /> 1_ Clothes washer � Clothes dryer <br /> _L Laundry iray � Range hood <br /> Sink Iservice/badmopletc.) ��` Exhavst fan <br /> Backflow prevenler � ` Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof Grains Olher <br /> � _ Other <br /> CITY OF EVERFTf LOCAL SALES SAX CODE IS 5105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correcL All provisions oi laws and <br /> ordinaces yoveming lhis type of work will be complied with whether specified herein or not Tha granting of a permit does not piesume <br /> to give aulhority 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 I comply with lhe <br /> State Con ctors Law 1827 RCIy an�i 296.200 WAC. <br /> i�G7'-. /-.� <br /> /j-� .�/r'� �-��. % � -:�-�r I <br /> Signature of OwnedContractodAuthorized Agent Date `�� <br /> / � <br /> .� <br /> � <br /> f - . ' . ` -: .w .� � .�t�;,.9�� a t tt � i.�, s r: <br /> ��..� r�..- ..z. - -,u �� -- s'"'" ����Yn y ��� q <br /> _ . . . �... . Y ... ,,,, _ `•, �M+c . r� S' b��� t� �� . � �. <br /> I1 <br /> :S �:.\. . ._ _ .. � � <br />