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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 <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CI?YIZIP PHONE <br />ec (k A-�Ec A <br />TENANT NAME CO TACT PERMIT PHONE i}-ZS-ZS`j '-O)37 <br />�F/O�R <br />1Q� <br />f�Y�/)" \ E-MAIL IL-CfJ�✓1�f��e}t�• <br />ONTRACTOR ADDRESS / \ CITY/ZIP PHONE <br />1�.1 <br />CONTR. LICENSE # <br />USE OF BUILDING r <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />5-' 1 l hxwym� <br />Electric _Gas _Other i <br />I <br />WnnO,,R,,K DESCRIPTION VyAb2j-t <br />PLUMBING <br />MECHANICAL <br />NO. � TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />_Forced <br />air systems <br />Gas piping <br />Water heater <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />_Gas <br />range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust tan <br />Barkflow prevenler <br />_Heat <br />pump <br />_ <br />Urinal <br />Unit neater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodslove <br />_ <br />— <br />Roof drains � <br />Other� <br />_Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have road and examined this application and know the some 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 authorit to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />ram horized b; the owner of this property to perform the work for which application is made and I ccmpty with the <br />aw.2RCN%and,296.200VdAC. <br />Nons <br />Own r/Co actor rized Ag nt ate <br />