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F �RMIT i4PPLICATI(��� <br /> CITY OF EVEi2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—wv✓w.everettwa.org <br /> APPLICATIONS ARE ArCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> SI'fE ADDRESS ^ ��� PARCEL TAX I.D.# P RMIT# <br /> ►141� ��;«'�� �e �- � �� -�-7 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CINIZIP PHONE <br /> �,piN �l.Opw�tJ`f �o R�c 1�"1 �r�lottD�t.tS,4t' W� `�82�1 42S 33�f 5�(8 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Is,�aJD1� �cc.m'� , ca�?cT�:� �k�"tr�'�75 �12531�P��`1 <br /> CONTRACTOR ADDRESS CITY2IP PHONE <br /> Pu6� w�s� co�P. p.o. gox �� �A-uNbTo� `1�223 425 2 R p �l�t�'' <br /> CONTR.LICENSE fl <br /> YU6eTl/J� �8��6 <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE O� NORK <br /> _Electric _Gas_Other I ��' � <br /> WORK DESCRIPTION <br /> �C�h1bcNT U�t'IISChIC� WJhI�� <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C—air handling units <br /> Bathtub Forced air sy,tems <br /> i.avalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Laundry lray _ Range hood <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> Back(low preventer _ He2t pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> �hereby ceritify that I have read and examined this application and knnw lhe same lo be true and correct. All provisions of laws and <br /> u:dinaces ctoverning lhis type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> to give aulhorily lo violate or cancel the provision of any other state or local law regulaling construcGon or the performance of <br /> construcli .That I am authorized b��the owner of this properly to perform the work for which application is made and I wmply with the <br /> Stale C tractor�,La�v 18. "'RCW and 296.200 WAC. <br /> ��a� �;✓ � r,s.a`_ <br /> na ure of OwnedContractod u orized Agent Dat <br />