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PERMIT APPLICATION <br /> CITY OF EVERETT 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 <br /> SITE���S Z� �f���/ PARCEL TAX I.D.# PER�T#1 > <br /> 3 � <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> E-MAIL <br /> !:ONTRACTOR RES C T /Z P P NE <br /> CONTR.LICENSE# �V�� �-�/ / � <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas_Other ���O � <br /> WORK DESCRIPTION <br /> �����'�/ (� Ot(.,C�/ ,�(/1/��l(�C-L/ — �ZUJ �C� <br /> % �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathlub L_ Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kilchen sink&disposal Gas flreplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> Water heater Range hood <br /> Sink (service/bar/mop/elc.) Exhaust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> 1=1oor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby certi(y(hat I have read�nd examined lhis application and know ihe same to be irue and correct. All provisions of laws and <br /> ordinances governing ihis type of work will be complied with whether specified herein or not.The granling of a permil does not presume <br /> lo give authority lo viclate or cancel lhe provision of any olher state or local law regulating construction or lhe performance of <br /> construction. That I am au�horized by ih owner of lhis property to perform the work forwhich application is made and I comply with the <br /> State Contr ors Layv RCW and 2 2001NAC. <br /> � <br /> � ignal o Owner/C tor/ horized Agent Date <br />