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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 q -)o -0? <br /> SITE ADDRESS ,; XX 6 GU PARCEL TAX I.D.p PERMIT R <br /> EVeWAN I x`609 <br /> LEGAL7 LOT NO BLOCK TRACT OR SUBDIVISION N <br /> OESC <br /> OWNER ADDRESSCITYIZIP PHONE <br /> J.a6 361"' 015w 4ew4I& `ta. <br /> TENANT NAME CONTACT FOR PERMIT PHONE (4;k5 34 3 38�, <br /> 101,4— <br /> ZaNTRJCTW.� I <br /> CONTR.LICENSE N lYN <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> " Electric _Gas_Other <br /> 7�_ ' r� •CT(^J <br /> WORK DESCRIPTION regal/' LA ItC.PI�CM _ e� �I�- "Itj- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> 0Bathtub Forced air systems <br /> _5 Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> �- Dishwasher Gas range <br /> Clothes washer I Clothes dryer <br /> _y Water heater t Range hood <br /> _ <br /> Sink(servicelbarlmopletc.) Exhaust fan <br /> _ Beckfiow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain Bailer <br /> _ Floor drain T Refrigeration <br /> _ Grease trap _ Woodslove <br /> _ Roof drains _ Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br /> I hereby coritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a permit does not prosume <br /> to give authority to violate or cancel the prevision 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 /> Slate Contracto L 18.27 CW d 298.200 WAC. <br /> Signature ofalure of OactorlAulhorized Agent Date <br />