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P "RMIT 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.# PERMIT# <br /> � v'1 r .ty I a v 'Ili , k 'v bel v ,a <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> 11 (ZO'(, ) 9q Z-,Q-7 Z S <br /> TENANT NAME CONTACT FOR PERMIT PHONE liq 2_.0-7 ZS-- <br /> E-MAIL—� <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE <br /> CONTR. LICENSE# <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> Pe-rMl+S, LooL-4,� 4-b <br /> Hzf <br /> PLUMBING 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 <br /> Kitchen sink& disposal ❑ PERMITS REQUIRED <br /> Dishwasher <br /> Clothes washer <br /> Water heater ❑ NO ACTION REQUIRED <br /> Sink(service/bar/mop/etc.) <br /> Backflow preventer ❑ RESOLVED <br /> Urinal <br /> Drinking Fountain NOT COMPLETE — SEND TO FILM <br /> Floor drain <br /> Grease trap ❑ MAINTAIN ACTIVE <br /> Roof drains <br /> Other <br /> ❑ OTHER: <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceritify 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 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. 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 /> State Contractors Law 1188.2277 RCW and 7270�AC <br /> J Z111710? <br /> Sig a ure r/Contrac or/Authorized"Agent D to <br />