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PERMIT APPLICATION <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 <br /> SITE ADDRE55 PARCEL TAX I.D.N PE[#MIT N , <br /> , , 4_ l/a - - - � r --,� � �05 .� 3c�� c� � � 9, o� ��k�� -c�`�� <br /> IEGAL LOT NO. BLOCK TRACT OR SUUDIVISION p <br /> DESC. <br /> OWNER AUDRESS CITYIZIP PHONE <br /> ,��-1L�--F '—" `��� � 1 n L�- � f'� �l C �.� �Ju�.Jn��.��'_ao c,� <br /> TENPNT NAME I CONTACT FOR E MtT PHONE <br /> E-MAIL <br /> �6RTRA�bR UjS�gg�— — <br /> CONTR.LICENSE N <br /> USE UF BUILDING H[AT SOURCE I CONTRACT PRICE OF WORK <br /> — � ;.�.• 1�� .:k" _Eledric _Gas_Other ��;; �(ti " <br /> WORK DESCRIPTION <br /> 1 � /11 � J <br /> K.! 9hf-( �e'�•/� '� Ii �.�..;' �� 4�!-��L�Y�7J�/7 � <br /> 1– � <br /> PLUIVIBING MECHANICAL <br /> NO. TYPE OF fIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilei A/C–air handling units <br /> Dalhtub forced eir syslems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kilchen sink &disposal __ Gas fireplace <br /> Uishwasher . Gasrange <br /> Clothes washer _ Clolhes dryer <br /> Water heater Range hood <br /> Sink(service/barhnop/ulc.) _ Gxhaust fon <br /> Oackllow pieveNer __ Ileat pump <br /> Urinal _ Unit heater <br /> _ Drinking Founlain __ Hoi�er <br /> Ploor drain __ Refrigeralion <br /> Grease Irap __ Woodstove <br /> Roof drains Olher <br />' -- Olher <br /> CITV OF EVERETT LOCAL SALES TA%CO�E 19 J105 <br /> I hereby certify Uiat I have read and examined this applicalio�ana know the same lo be true and correct All provisions ol laws and <br /> ordinances goveming Ihis typ�of work wdl be complied wdh whelher specified herein or not. The granting of a permil does not presume <br /> lo give auUiority�o violale or cancel Ihe provision of any o�her state or locel law regulaling construction or Ihe peAormance oi <br /> conslruction, Thal I am authorized by Ihe owner of Ihis property to per(orm Ihe work for which epplication is mede end I comply with tlte <br /> Slate CoNractors t.aw 18.27 RCW and 29�0 W�C, <br /> .C,��' � s�:., �� , �- � �' —� c � O <br /> Slyn�o�OwnedConlractor/Au�horizedAgen� Dale �� <br />