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� <br /> � <br /> I � ' <br /> ��c�-a �� �� �— �, ��� <br /> c � <br /> . <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMtT SERViCE� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 T �� <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org �— <br /> , <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRES PARCE TAX I.D.# PERMIT�' �� <br /> � <br /> LEGAL LOT NO. BLOCK TR CT R SUBDI SION# <br /> DESC. <br /> R ADDRESS ��C �� CITY/ZIP PHONE <br /> / J <br /> TENANT N E CONTACT FOR PERMIT PHONF'w� Z�r �� <br /> I r <br /> � E-Ma q� <br /> CONTRACTOR DDRESS CITYIZIP PHONE � � <br /> _ ��� �(ob� S t 3�p..Q S.e�.�.c. �.�C (��l <br /> CONTR.LICENSE# ��� ^ ,..,, �� <br /> �tJ <br /> USE OF BUILDING HEAT SOURCE CONT�ACT PRICE OF WORK <br /> _Electric _Gas_Other <br /> WORK DESC PTION („� � ' ' � C���. �� <br /> v�- I�- S� � ,,�- a..�a � <br /> PLUMBING . MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTU�E OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas firepiace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> � _ <br /> � <br /> GITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 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 /> ordinanc verning t ' e of work will be complied with whether specified herein or not.The granting of a�ermit does not presume <br /> to give uthori to viol e or a cel provision o n ther state or local law re lating constr ction or the performance of <br /> const tion. a a ut ri d b he owner o this pr erty to perform the wor for which ap lication is made and I comply with the <br /> State ntr ct rs La 27 a 296.200 AC � <br /> � � <br /> f wner/Contractor/Ruthorized en Date Z� <br /> S�gnature o 9 � <br /> ".•.:--...� • <br />