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% <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE'�, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (p � S—O �o <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 0700 �5 �� sf O61 0 -OOZ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> o�C./'/'y � f/n;�c �ano �92// 8`NS /�.�c n/E Arl;��fe.. 95223 3Go-43S•7oGS <br /> TENANT NAME CONTACT FOR PERMIT —� PHONE <br /> /✓�'f' eCG�ry �rwno 3Go • y35� ^,OGr <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> dw��� <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> _Electric LY Gas_Olher <br /> WORK DESCRIPTION <br /> �C�+O ��SLj CK�S-r..�' �041'C 4i1cY G/'4 G- <br /> PLUMB NG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A!C–air handling units <br /> Bathtub Forced air syslems <br /> Lavalory(wash basin) Gas piping <br /> Shower Waler heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Ciolhes washer Ciuthes dryer <br /> Water healer Range hood <br /> Sink(service/bar/rrop/etc.) Exhaust tan <br /> Backflow preventer Heatpump <br /> Urinal Unit heater <br /> � Drinking Fountain Boiler <br /> F�oor drain Refrigeralion <br /> Grease lrap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � hereby cerilify thal I have read and examined this application and know lhe same to be lrue and correct. All provisions of laws and <br /> ordinaces governing lhis type o(work will be complied wilh whe�har speciTied herein or nol.The granling of a permit does not presume <br /> lo give aulhority to violate or cancel lhe provision o(any other state or Iocal law regulating construction or the performance ot <br /> conslruction.That I am authorized by the owner of this property to pedorm the work for which appiication is made and I comply with the <br /> Stale Contraclors Law 1827 RCW and 296.200 WAC. <br /> �.tn�,.�„ _ �q�.- ��'S- O� <br /> S g�aWre o(Ow dCoNrector/Authorized Ac�enl Date <br />