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PERMIT APPLICATION <br />CITY OF EVERETT PFRMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-257•8810 - FAX 425•257-8857 - www everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS c..vuc.�� � <br />�t�l� LS' <br />LEGAL LOTNO. BLOCK TRACT <br />DESC <br />�WN R OORE <br />R�san��o�ne�l,,c. �oia� �reRqr�c� <br />TENANTNAME I ONTA <br />PARCEL TAX I.D. M <br />CO TRACTO�R/ ` 1� ` ADDRE58r.`��r� u CITY2IP <br />�r��...iill\ `V'�•`�✓� �-:�� Ju�'�e WV�I�EI <br />CONTR. LICENSE M <br />,q-,r�TzSNs �iSSL3 <br />USE OF BUILDING I HEAT SOURCE <br />��� � _ Hectnc �[ Ges _ Ulher <br />WORK DE:iCRIPTION <br />�JU,S�C� �' (��- <br />PLUMBING <br />�JO. I TYPE OF FI%TURE JR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash bss�n) <br />Shower <br />Kitchen sink B disposal <br />DiShwasher <br />Clothes washe� <br />Leundry tray <br />Snk (service/baumop'etc ) <br />BackOow preventer <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Graase t�ap <br />Roof drains <br />Olher <br />P j2M1T M / <br />�� ��-�ls� <br />�. <br />PNONE <br />, <br />��� g� � <br />PNONE <br />��-�{'1� -f�ty'1 <br />PHONE <br />CONTRACT PRICE OF WORK <br />\�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />FVC - air handling units <br />Forced air systems <br />Gas pipmg <br />Water heater <br />Gas f�replece <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Umt heater <br />Boiler <br />Refngeretion <br />wooastove <br />CITY OF EVEREiT LOCAL SALES TAX CODE IS 7106 <br />I hereby centdy Ihat I have read end exemined ih�s applicahon and kno�N ;`e same to be true anC correct All provisions ol laws and <br />ordinaces goveming this type ol work wdl be compl�ed wilh whether speafied herem or not The qranUng ol s permd dces not presume <br />to grve aulhoi�. to violate or cencel ihe provision of any other slele or local law regulahng construchon or the perlormance of <br />consVucfion. Thol 1 am authonzed by the owner of this property to perlorm the work for which appl¢alion is matle and I comply with the <br />Slate Contra�tors Law 18 2' RCVy an� 296 200 WAC � � <br />'�I Signature ol wner on!�a toriAuthorized Agent � ` Da!e � <br />� <br />