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P'�RMIT APPLICATIGN 1 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, 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 ADORESS -�-., � �„yi PARCEL TAX I.D.# P RMIT# <br /> � ,G. �rU Z ��.� .��- 7�. ������ � � � � �I� ��J� <br /> � L�� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS CITY2IP PHONE [��,j- �j - � <br /> /L� �1rrvlCin ,i ��fl,�f�� P 7 �)Pl��� � Z��oZ �lJ U�S+ Sc - EvCVC.t�: UJ! �1�Z �� <br /> TENANT NAME CONTACT FOR PERMIT PHON <br /> S(i /L-1 (" <br /> �((/l � -� 5 (� {ti� � <br /> CONTRAC?OR ADORESS CITY2IP PHONE <br /> CONTR.LICENSE# ���'���"��t-� <br /> 11SE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �� �G�� Eloctnc Gas Other <br /> WORK �ESCRIPTION /' /" �" � / �f �- T � , �y �-'�� <br />, � c//��-(�� /�D-��'✓\ �n.r /n c� G"� " 1�� '� � l ' �f����� <br /> //_ 7 i <br /> �t..�l: r� -�". .-�u�r.J /�t' �-I�iL' b' M �.�.. <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Tollet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas ran4�e <br /> Clothes washar Clothes dryer <br /> I = Laundry tray = Rsnga hood <br /> Sink(sorvice/badmop!etc.) Exhaust fan <br /> ' Backllow preventer Heat pump <br /> Unnal Unit hr,aler <br /> Drinking Fountain Boiler <br /> Floor drain Refngeratinn <br /> Grease trap Woodstov�� <br /> Roof drains Othar <br /> Olher <br /> CITV OF EVEHETT LOCAL SALES TAX CODE 19 3705 <br /> I hereby centify that I have read antl axamined lhis application antl know the same to be true and correct. All provisions of laws and i <br /> , ordinaces govemmg this type ot work will be complied wilh whether specifie0 herein or not. The granung of a permit does not presume i <br /> ' to grve authonry to violate or cancel tha provlsion of any other state or local law regulating construction or the peAormance of <br /> construction. That I am authorized by the owner of this prope ,ry to peAorm the work for which application Is made and I comply with the I <br /> St te Contractors Law 1 27 RCIh' and 296.200 WAC. I <br /> f � 1� ��1 � � Q��� �— ' U ��'�� <br /> �Sig ature of Ownen ontrectovAuthonzed Agent ate � <br /> � — i <br />