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�r - - -- - <br /> �- PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-wvrW.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.K PERMIT tT <br /> '/ i �il 8 oD o o IYl I Z I l-D <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION 0 <br /> Dil <br /> OWNW/NWjER A ADDRESS ICI\TY2IP PHONEG�p '� <br /> TENANTNAME CONTACTFORPE`RMIT PHONE 1/20 :Sl I't1, <br /> -SLa <br /> CONTRACTI IR�,2dlfe ,7.r7t-cica' �r.7 7 .!A <br /> CONTR.LICENSE/ �G�y' �Q.LG� ��/s • � � `ry� '(� <br /> �a.slr�7• '/3LD� Irv, s �t Fcr�r9 98u�y - '�y <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gall Other 2.3015 <br /> WORK DESCRIPTION ,�� �L'[ttt 'E-lll+�jt�S.It4-L-C�' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ <br /> Toilet AIC-air handling units <br /> Bathtub = Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> _ Shower Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer _, Clothes dryer <br /> _ Water heater Range hood <br /> _ Sink (service/bpletc <br /> er/mo .) Exhaust fan <br /> _ Backfiowpreventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> _ Grease trap — Woodstove <br /> _ Roof drains — Other. <br /> Other. - <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances governing this type of wurk will be complied with whether specified herein or not The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Co tractors Lew 18 27 RCVV nd 296 2Ob WAC <br /> f '-li r <br /> Signature o Owner/ onVactorl uthonzed Agent ata <br />