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PE. IMIT APPLICATIO�. <br /> CITY QF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT, V��A 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED � <br /> SITE ADDRESS PARCEL TAX I.D.# PE fiA T# I <br /> � �9 - :, � - � � • oy 90 — <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNFR ADORESS CITY2IP PHONE <br /> I <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> C...V�\+bDfnT�L (St�� LL <br /> CONTRACT R ADDRESS CITY2IP PHONE <br /> CONTR.LICENSE# <br /> USE OF BUILDIN3 I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION n � <br /> �� -����� G <br /> � G�� <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIX7��RE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> �_ Toilet A/C—air handling unils <br /> Bathtub Forced air systems <br /> �_ Lavatory (wash basin) Gas piping <br /> _ Shower �_ Waterheater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washr:r Clothes dryer <br /> Laundry tray Range hood <br /> _L Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heatpump <br /> i _ Urinal _ Unit heater <br /> Drinking Fountain �oiler <br /> I _ Floor drain Refrigeration <br /> Grease trap Woodstove <br /> ' Roof drains Other <br /> Olher <br /> i — I — <br /> ' CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I _ <br /> I hereby ceritify that I have read a��d examined this application and 4now the same to be true a�d correct. All provisions of laws and <br /> ordinaces goveming this type or eiorK will 6e complied with whether specined herein or not.The granting of a permit does not presume <br /> to give authonty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction. That I am authorized by'he owner of this pmperty to perform the�vork for which application is made and I comply with Ihe <br /> ' State Con�ractors Law 18.27 RCl'�'and 296.200 WAC. <br /> ��;-� r� �t,�� � 1 �- � -�o�t <br /> ISignawre ot OwnedContractovAuthonzed Agent Cate <br />