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Or.RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everett",a.org <br />APPLICATIONS %RE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS n— 31 <br />PARCEL TAX I.D. # <br />I <br />P RMIT# <br />603 C/-Y.S /^/ 0 /LJ <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION p <br />DESC. <br />OWNER ADDRESS CITY2IP PHONE <br />Go& rUG <br />TENANT NAME CONTACT FOR PERMIT RHOI�E n s�y <br />6�EIN'4 �5, 3/7 <br />bSoN/�n�� <br />E-n1AJLaL <br />CONTRACTOR wob"SS CITYIZIP PHONE <br />'I"> D <br />CONTR. LICENSE p <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric —Gas —Other <br />I <br />5 � D00 <br />WORK DESCRIPTION <br />UPr aa-�7E /LGST2op/'Y1 5 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilot <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink & disposal <br />_ <br />Gas fireplace <br />_ <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />_ <br />Water heater <br />_ <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backgow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease (rap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />_ <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 />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 authurity 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 qy the owner of this property to perform the work for which application is made and I comply with the <br />Stat Conaw 10.27 RCV0nd 296.200 WAC. -7/n /vrr/7 <br />Signature of Owner/Conlractor/Authorized Agent Date ��Z <br />