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' PERMIT APPLICATION <br /> CITY OF EVERrTT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-A810 — FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �ITE ADDRESS �, PARCEL TAX I.D.# PERMIT p <br /> /l,"- //�a s�_: �l �, ; `J� � - c, c;L. <br /> LEGA LOT NO. BLOCK TRACI�OR SUBDIVISION M <br /> DESC. <br /> OWNER AODRESS �j � CITYIZIP PHONE � S <br /> ��— �' . � 39 • �lpS/� <br /> ` > ,<z: v, .'?< . •�, ' /�' .1 l�t,� r.�cr •L r1�'<� �'7 <br /> T NT NAME CONTACT R PFO ERMIT � PHONE <br /> ��— <br /> E•h:AIL <br /> CONTR.LICENSE M <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Gas Othor <br /> WORK DESCRIPTION <br /> ��! � � '�[I ..� � /�J �.I�� � // L'� <br /> I <br /> PLUMBIN MECHANICAL <br /> N0. TYPE OF FI%TURE O ITEM NO. TVPE Of FI%TURE OR ITEM <br /> Toilcl A/C -air handlinc�units <br /> _ Ba011ub Forced air syslems <br /> _ Lavalory(wash basin) Gas piping <br /> Shuwer Wal�i heator <br /> . _ Kitchnn sink 8 Aisposal _ Gas lireplace <br /> Dishwashnr . Gasrange <br /> _ Clolhr,s washer _ Clolhes dryor <br /> . Watm hoater _ Ranc�o hood <br /> Sink (scrvir.e/barhnop�atc.) Exhausl(an <br /> Oackllow prAv�nlor � Heat pump <br /> Urin�l Unit healer <br /> Drinkinc� Founlain Boilar <br /> Floor drain Relrl�eration <br /> Gioaso tr:�p Woodslove <br /> Roaf diains Other <br /> Olhc+r <br /> CITY OF EVERETT LOCAL SALES TA%CODE 19 7105 <br /> I hereby corilify thal I have reaA and examinad�his application and knmv ihe same lo be irue and coirect. All provisions of laws and <br /> ordinaces yoaerning Ihis type ol work will be complieA wilh wheUier speciGod herein or noL Tha granling ol a permi�does not presume <br /> to�ive aulhorily!o violatr. or cancol Ihe provision o(any olher slato or local law regulating consl«ictlon or Iho pertormance ol <br /> conslruchon. Thal I am aulhorized by Ihe o�mnr ol�his propehy�o pedorm ihe work lor which applicalion is made and I comply with the <br /> Stale Conlr�r.lors Law 18.27 RCW and 2Jf.200 WAC. <br /> • -'', /.J ,��' �� -�J�7 <br /> gnalure o OwnedConl .orlAuthorizeA Agent Oale <br /> I <br /> i. . _ _ . . _. __. . . . - ---...------------.._—.____.---- �— <br />