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p,Y����• •e••• <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � ,,. a V `QC� <br />1 <br />SITE ADDRESS <br />�/ <br />PARCEL TAX I.D. n <br />PERMIT 1t <br />KO <br />1 � S-l- S Wul <br />Oq0 - 0 <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISIONR <br />DESC. <br />OWNER ADDRESS CITY2IP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE 7�.r'�O �• %!O� <br />TxF�n�`Ar� <br />VeY <br />E�l.1AIL Q <br />(:iwm�' <br />`� FreAc�e � D �T Id�3 .1I548 46q <br />Y1GW►'1 F1��p`!O}�ChC3Yl � �Ox IZ113 H?.s•N$I.7(o6� <br />�CO L,NICE1N � � r���� Cr��k uL7/� qf�2 <br />tz� e`"iMut <br />� <br />�13E OF BUILOINO <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />�����n11'l/VIQ.V'(�.{Q` <br />—Electric _Gas —Other <br />WORK DE CRIPTION <br />"PmY�;��,.�sr,r <br />w,mMs <br />C7) �f�rL spr�r�k�er 1�eoc%S <br />Reloca}e., cy) �vvt s Yly�k.�QJ!' hPr�S <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />A/C — air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />_ <br />Shower <br />Water hector <br />_ <br />Kitchen sink 8 disposal <br />_Gas <br />fireplace <br />_Gas <br />range <br />_Dishwasher <br />Clothes washer <br />_Clothes <br />dryer <br />_ <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust Ian <br />_ <br />Backllow preventer <br />_Heat <br />pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boller <br />_ <br />Floor drain <br />_Refrigeration <br />_ <br />Grease trap <br />Woodslove <br />_ <br />Root drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cedlily that I have road 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 complird 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 />etY�. <br />�_a.,....�s4w <br />construction. That I am authorized by the owner of this property to perform the work for which application is made end I comply with the <br />Ste ntredor6 Law 13.2 CW and 296.200 WAC. <br />i <br />ign ure of nen ont actor/ uthonzod goof a e <br />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 />ADDRESS PARCEL <br />