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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 /> SIT ADDRESS F PARCEL TAX I.D.# PERMITS <br /> LEGAL LOT NO.ESCT �o BLOCK TR T <br /> DWNE J• per- B-K _ u �� <br /> WNER ADDRESS CITY2IP PHONE (yz5),/x, %2,3 <br /> TE ANT NAME CUPre*ICO TACT FOR PERMIT PHONE <br /> , <br /> CONTR bTOR rrt �� AD RESS CITY + ONE <br /> J` ' f �yvv i��r*Zn &d EvWj 9��8 Hzs�v'Ic+ �3s <br /> CONTR. LICENSE#--p <br /> x� /1 0 <br /> USE OF )11LDING ( ( I I HEAT SOURCE CONTRACT PRICE OF WORK <br /> 1 t Electric _Gas_Other l�r� OD <br /> WORK DESCRIPTION \latall(.t) eRch 75 'x46,1 0mr- SrcLe nOn lit '0-{ruded alUmtn-tun <br /> }�Sic h (1AbI✓tei w/ Ajo--+a) drVlder ba► 5 r (10) eneh bkzn�whr Di{�loAci (e►azirl <br /> nrls 'per ��, *� 111Du-,�+ctq VM ��onF c>7 exl�trr®J cr�ne► M monumenf <br /> I(i" Qla�PtdU �p►1,,tAF1 �ItS �rrm1RuM In IeYIr1�h, <br /> rLUMBINU J MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet _ A/C—air handling units <br /> _ Bathtub _ Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> _ Shower _ Water healer <br /> _ Kitchen sink 8 disposal _ Gas fireplace <br /> _ Dishwasher _ Gas range <br /> _ Clothes washer _ Clothes dryer <br /> _ Water healer _ Range hood <br /> _ Sink(service/bar/mop/etc.) _ Exhaust fan <br /> _ Backflow preventer _ Heal pump <br /> _ Uimal Unit heater <br /> _ Drinking Fountain _ Boller <br /> _ Floordrain Refrigeration <br /> _ Grease trap _ Woodslove <br /> _ Roof drains _ I Other_mjO��lXr <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br /> I hereby cerilify 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 authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> conslruGWn. at I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> S4ino tra rs Law 8.27 RCW and 298.200 WAC. "Oslo <br /> e ner on rector uthorized gent ale CO <br />