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PE� :MIT APPLICATIO`�. <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 ADDRESS �L � � �� ' PARCEL TAX I.D.# PERMIT# <br /> " GID ► Z 3 � I !3 -� ov �r -oz.o <br /> LEGA LOT NO. B!_OCK TRACT OR SUBDIVI510N X <br /> DESC. <br /> OWNtR � ADDRESS CITY/ZIP PHONE <br /> SeawR-� C��rn��c _ <br /> TENANT NAME —T � CONTACT FOR PERMIT PHONE 3� U b 6 I y(Jc� 5 <br /> wAS�1�1G�1 UN {�.vj 0/�.t/4J�2/J SG�� /�UGLC�s E-MAIL <br /> �� ?bo 66/ - <br /> 'Zc6FqkA�A I ry �� L 6YI/j(/�b P�l�� k i44 7 S TfiN c✓�uD, wfF �b ��! L L u o � <br /> CONTR.LICENSE 8 <br /> USE OF BUILDING HEAT SOURCE CON'i RACT PRICE OF WORK <br /> - _Electric _Gas_Other � t��$ p U� <br /> T n • rl Iw,r�r�a � �i <br /> WORK DESCRIPTION <br /> i PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> � Toilet _ A/C—air handling units <br /> Bathtub Farced air systems <br /> � Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> 1 Water heater Range hood <br /> Sink(service/bar/mop/etc.) _ Exhaust fan <br /> Backflow preventer He:�t pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woadslove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and ex�mined ihis applicalion and know ihe same to be tnie and correct. All provisions of laws and <br /> ordinances governing this type of work will be complied with whether specified herein or nol.The granting of a permit does not presume <br /> to give authority to violate or cel the provision of any other slate or local law regulating conslruction or ihe performance oi <br /> construction.That I am authorize by the owner of this property to perform the work for which application is made and I comply with the <br /> State Contra tors Law�8'�' C and 296.200 WAC. <br /> �.�"ll �-� -�v <br /> Signal e f ner/Co ractor/Authorized Agent Date <br />