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r - - - <br /> � PErtMIT APPLICATIO�� <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVF_RETT, WA 98201 <br /> 425-257-8810 - FAX 425-?_57-8857 -www.everettwa.org <br /> I APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS I PARCEL TAX I.D.p PERM T p <br /> 25 /�C'� 5 i � �/ S <br /> LEGAL LOTNO. BLOCK 7RACT <br /> DESC. <br /> OWNER AODRESS CITYI2IP PHONE 338 ��by <br /> I��nr,�„ V,J ��Soij 2225 M /OoU'S1'SE � fiuC.er� w!9 9�2ug y2S� <br /> TENANT NAME I CONTACT FOR PERMIT pHONE <br /> 1�o s � �- 1 n c9.��t P.(� 5 5 �- � n(J� � 4 ��25- '-122- G 2$ol <br /> CONTRACTOR - ApDRESS —� CITY2IP PHONE <br /> CONTR. LICENSE p <br /> USE OF BUILDING HEAT SOURCE � CONTRACT PRICE OF WORK <br /> _Electric �Gas_Other I <br /> WORK DESCRIPTION C �7 �� <br /> � • �O/ r� cw r� <i � Scr.�� cc , <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OP FIXTURE OR ITEM <br /> Toilat A/C—air handling units <br /> I = Bathtub Forced air systems <br /> Lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> � _ Kitchen sink 8 disposal � Gas fireplace <br /> ' _ Oishwasher Gas range <br /> Clothes washer Clothes dryer <br /> I _ Laundry tray Range hood <br /> _ Sink(servicelbar/mop/etc.) Exhausl fan <br /> � _ Backflo�v preventer Hea�pump <br /> Urinal Unit heater � <br /> Drinking Fountain Boiler <br /> _ Flooi Arain Refrigeration <br /> Grease trap Woodstove <br /> � Root drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE I$�105 <br /> I hereby ceritlfy that I have read and ezamined this application and know the same to be We and correct. All provisions of laws and <br /> ordinacas governing thm type o(work will be complied with whether specified herein or not. The granling of a permil does �ot presume <br /> ro grve authonty to violale or wncel the provision of any other state or local law regulating construction or the pe�formance of <br /> constj tion. Thal I am autho�by t wner of this property to peAorm the work for which applicatlon is made and I comply with the <br /> �lata'C ntracrors Law �8.27 C' d 95.200 WAC. <br /> � /L� - .2� - v <br /> 9�gna u 9 w enCornrec nAutho gent ate <br />