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PL�2MIT APPLICATICr�J <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS cS/ YH� Gl! ��/?C/ PARCEL TAX I.D.# PERMIT# <br /> ll�ly �fh �4✓e, J�.E. C � � �� <br /> LF�A LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORE55 CITY/ZIP PHONE <br /> M�'I'�a^ Jgv��� /�l✓e�I`ine�}S <br /> TEI �NTN���/� h(///`-r� I �V� FOl�E�p����� �-2sN�e9•ybo9 <br /> .K�r � <br /> CONTRACTOR ,�e���y Pn/J P/' CO. �IC,�ORESS P(�.Lt7+( B2/0� CITY21P�ry,yy�2�PHONE <<�-�4999� <br /> CONTR.LICENSE# /'7��['U.J�C ��7 OE /�� <br /> US�j,�F BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �" '« /���� Electric Gas Other �7��•�� <br /> WORK DESCRIPTION � ��J�.�J// /1� J`�j��/��C�/' ��"/��f �jf' /7Py,l �jI/fhPC� OUf <br /> �tif,�llS/'��e. ss �nPw ���i,-�/er� 7`a�/ �i��/��oy �� stU�-�Ps. <br /> �/so) . <br /> PLUMBING MECHANICAL <br /> NP. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal 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 /> i _ Unnal _ Unit heater <br /> Diinking Fountain Boiler <br /> Fl�or drain Refrigeration <br /> = Grease trap — Woodstove • s <br /> Roofdrains Other�f����T �E�� 3 <br /> Other <br /> I _ <br /> CITY OF EVERETT LOCAL SALES SAX CODE IS 7105 <br /> � <br /> iI hereby ceritify that I have re�,6 and examined this applicatlon and know the same to be true and correct. AII provisions of laws and <br /> ordinaces governing th's type of w rk will be complied with whether specified herein or not.The granting of a permit does not presume <br /> , to give autho ' to ' la e or c el the provision of any other state or local law regulating construction or the performance of <br /> iconstr . Th I am t d by the owner of this property to perform the work forwhich application is made and I comply with the <br /> Sla 6.200 WAC. <br /> I / /�J /z-s3 D <br /> Iignature of Ow d o ractor/Authorized Agent Date ��L <br />