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P RMIT 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 5--�� <br /> �� <br /> SITE ADDRESS PARCEL TAX I.D.if PER� IT <br /> /.��o �:��� ��' '� �� <br /> LEGA LOi NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC.� <br /> OWNER ADDRESS CITYIZIP PHONE <br /> Se�S�y �/"��p��✓'��f �7�6 r�� �"i ,' ,y� Or. G , � . �� %CdG� <br /> TENANT NAME I CONTACT FOR PERMIT �— PHON�—� �, <br /> E.MAIL <br /> N R S <br /> Te r��� rIE'-��✓e r,�/�o f- <br /> CONTR.LIC NSE# � <br /> USE OF BUILDING HEA� SOURCE CONTRACT PRICE dF WORK <br /> /^/ ,y Q,A <br /> �/��, �C'.?��/��t�i� _Electric _Gas_Olher `H 7J �C� � <br /> ✓ <br /> WORK DESCRIPTION (�c`��`Q ` ,'���� �e�C�I` r <br /> � <br /> PLUMBING MECFiANICAL <br /> �.JO. TYPE OF FIXTURE OR ITEM NO. TYI'E OF FIXTURE OR ITEM <br /> Toilel _ A/C-air handlinc�units <br /> Bath�ub Forced air systeins <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water healer <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Cbthes dryer <br /> Waler heater Range hood <br /> Sink(service/bar/mop/etc.) _ Exhausl ian <br /> Backflow preventer Heat pump <br /> Urinal Unit healer <br /> Drinkin� Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease lrap _ Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVEREST LOCAL SALES TAX CODE IS 3l05 <br /> I hereby ceritify that I have read and examined this application and know lhe same to be true and coirect. All provisions of laws and <br /> ordinaces governing lhis rype of work will be compGed wilh whether specified herein or not.The granting of a permit does not presume <br /> to give authorily lo violale or cance�lhe provision of any other stale or local law regulating conslruction or the performance of <br /> constructiun.Thal I am aulhorized by lhe owner of this property lo per(orm the work for which application is made and I comply with the <br /> Slale Conlraclors Law 1827 RCW and 296.200 WAC. <br /> ��r('I'% ��h,�-+i'sa%G' �S/�� ��� <br /> iynatur oF Ow er/Contraclor/Aulhorized Ac�enl a� <br /> /��C/I C fC'/` <br />