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� <br /> PE'�.MIT APPLIC,ATIOI� <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 PARCEL TAX I.D.# PER IT# <br /> 3.� � /��� s,�. ��/o� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDP.ESS CITY2IP PHONE <br /> TENANTNAME CONTACTFO PERMIT PHONE <br /> ��f�C - �. /�lf��� �cE I �ta ����r �/�S-�D's�Y� <br /> �CON RACTOR AD SS � CITYZIP , O E <br /> ide�r,!'�?•r �iHl�c� �P �3/! �5�� fii.E Sc� ;.re�n«a����' ?=3S'=�S'/ � <br /> ONTR.LICENSE k <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> _ �� � �� Electric Gas Other ���,�, <br /> � � <br /> WORK DESCRIPTION / <br /> /�4'w, ��N'S � /�� CF/��S /��Pr11� ��/ro`�<<'k'p� <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 /> BathWb Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water haater <br /> Kilchen sink$disposai Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit hea;er <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains � Other—'�� <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby r,eriti(y lhal I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces govarning this type of work will be complied with whelher specified herein or not.The granting of a permit does not presume <br /> to give au ority to violate or cancel the provision of any other state or local law regulating construction or the pertormance of <br /> constructi .That I authoriz by the owner of this property to perform the work for which application is made and I comply wilh the <br /> State C ractors 18.27 and 296.200 WAC. <br /> '� �-�''t J'�' <br /> Signa of ner/ContractorlAuthorized Agent Date <br /> \ ( <br />