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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 PARCEL TAX I.D.9PEOF2MIT p �7 <br /> J(CC)� I-g4Sc: !li' g 9 Lc r>:,a LCO , - r <br /> LEGAL LOT NO. BLO K TRACT"f l�, <br /> DESC. 11 <br /> OWNER. /A/DpRESS CITYIZIP PHONE <br /> TENANT NAME O7FOR PERMIT roD PHONE <br /> C0,4�Tr�RA�CTOR • '• ADDRESS CITY IP PHONE <br /> lSGcONt <br /> c r, es P,.(-13 A4-12 .1 <br /> CONTR.LICENSE%3A-CA 1Z 61--ZjS-,?4 r S Z�' /-�� � -�. �(t`�G�>USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> �l <br /> ;"�(7� ',�-2 _Electdas_Other <br /> WORK DESCRIPTION <br /> 3� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced air systems <br /> C7 Lavatory(wash basin) Gas piping <br /> Shower I Water healer <br /> = Kitchen sink 8 disposal Gas fireplace <br /> I Dishwasher Gas range <br /> Clothes washerClothes dryor <br /> Water hearer Range hood <br /> _I Sink(servicelbar/mop/etc.) Exhaust fan <br /> _ Backflnw preventer _ Heal pump <br /> Urinal Unit healer <br /> _ Drinking Fountain _ Boiler <br /> _ Floor drain _ Refrigeration <br /> _ Grease trap _ Woodslove <br /> _ Roof drains Other _ <br /> Other - <br /> -I — <br /> CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br /> 1 hereby eedlify 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 typo of work will be complied with whether specified herein cr not.The granting of a permit does not presume <br /> rI to give authority to violate or cancel the prov Ion of any other state or local law regulating construction or the performance of <br /> construcli hal I em authorized by the nor of this property to perform the work for which application is made ane comply with the <br /> SlateMnlraclo Law 1827 RCW end 6.200 WAC. <br /> Signa re of ner ntr or/ norized Agent is l/ <br /> Z <br />