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PLRMIT APPLICATIGA <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 PM - DEBIT 8 CREDIT <br /> ' CCA�RRDDSARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.ACOSC4 0 <br /> /Z <br /> LOT <br /> LEGA LOT NO.., BLOCK TRACT 7 <br /> DESC. �, <br /> Cot I20Z - o I I - 0-. <br /> OWNER ADDRESSCITY/ZIP PH <br /> QNE <br /> fi�Ml3 l� 'NG fs[ I Ste 900E <br /> TENANT NAME I CONTACT FOR PERMIT PHOUE <br /> CONTRACTOR 1 ADDRESS CITE/zIP PHONE <br /> I <br /> CONTR.LICENSE p3f1 _C- f�lZ <br /> USE OF BUILDING I — HEATSOURCE I CONTRACT PRICE OF WORK <br /> VElectric Gas Other <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> J Toilet hC-air handling units <br /> TL Bathtub T Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> _ Shower _L Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher i Gaslange <br /> Clothes washer i Clothes dryer <br /> Laundry tray I Range hood <br /> Sink(servlce/bar/mop/etc.) Exhaust fan <br /> _ Backflow preventer Heat pump <br /> _ Urinal Unit healer <br /> _ Drinking Fountain __ Boiler <br /> _ Floor drain _ Refrigeration <br /> _ Grease trap _ Woodstnve <br /> _ Roof drains Other_ <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cenlify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinates governing this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give aulho0ty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.That I am autholfzed by the owner of this property to perfo .the work for which application is made and I comply with the <br /> Stale antractors Law 18.2 RCW and 296.200 WAC. <br /> Signature of Uwner;Gfrac or/Aulhonze Agent t <br />