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PERMIT APPLICATIUN <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 <br />PARCEL TAX I.D. # I PERMIT # <br />-705- 3 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CITYIZIP PHONE <br />7'I; u + �1 A1DR C�HGAR � l C 3-3 �`` 5T �✓ERE➢7- 9eZo/ (Y'v),J52 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONT <br />v—S LB—Iy% <br />�G�RA'/D/J.'!Oro COPS/ ,5`S'LsSC.���,.� L.Xj c"Ao �a+P>� <br />CONTR LICENSE # �l 4i.�PH03E1 <br />T��r '-_'y0/3e;� 7L7f0 4t5--- <br />USE OF BUILDING f <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />— Electric Gas Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />lhtub <br />F.rced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow prevenler <br />�_ <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of wont will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale 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 the <br />State Contractoors Law 18.27 RCW and 296.200 WAC. <br />Signaatyre'of Owner/Contractor/Authorized Agent ,9we <br />