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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 ADDRESS <br />PARCEL TAX I.D. # I PERMIT # <br />-o- 44, <br />oo 52.4 n5 z-nL4cJ dd <br />LEGAL LOT NO. <br />BLOCK <br />TRA%J.OSSUBDIVISION # <br />�j <br />DESC. <br />'L--4 <br />1 I %`6 .� I �7 `, <br />? <br />OWNER ADD1RESS --1j7� CITY2IP PHONE <br />Z `� �� !Skw-,- <br />S Y <br />TENANT NAME <br />CONTACT FOR PrEdRMITI PHONE. /+' <br />J"i�y> <br />—yy-- <br />E-MAIL <br />CONTRACTOR —A66RES <br />CONTR. LICENSE # --- <br />USE OF F BUILDINGr�//►1�1� <br />��!Ot <br />ICONTRACT PRICE OF WORK <br />, I <br />✓r1--Gas _ Other <br />WORK DESCRIPTION <br />I e1.1�b JG— <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C - air handling units <br />Bathtub <br />_ <br />Forced air systems <br />Lavatory (wash basin) <br />— <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />--- J_ <br />Exhaust fan <br />_ <br />BackOow preventer <br />__ <br />Heat pump <br />_ <br />Urinal <br />__ <br />Unit heater <br />_ <br />Drinkin j Fountain <br />_ <br />Boiler <br />_ <br />Floor Crain <br />_ _ <br />Refrigeration <br />_ <br />Cross.) trap <br />Woodstove <br />_ <br />Roof drains <br />__ <br />Other <br />_ <br />Other. <br />— <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 />ordineres 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 authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. Tnat I am authorized by the owner of this properly to perform lhr wort, for which application Is made and I comply with the <br />State Conlr is Law 18.27 RC c,d 296. 0 WAC. <br />D / <br />p� <br />Slgnalu a wn /CC niractor/Authodz d Agent ate II <br />