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. � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 i <br /> 425-257-887 0—FAX 425•257-8857—www.everettwa.org <br /> I� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TA7f I.O.N P,�RMIT N <br /> c�c�r' �. (��5ra��e� ,�� �D3 � GL��'D C' /S 0 ��'(v •pS <br /> LE6A LOT NO. BLOCK TFiACT OR 6UBDIVISION I ' <br /> DESC. <br /> O E � I � 21P HO E . �rj • <br /> r / • -��1 �J E� ��� ��' 7GX� J�PI!e�A'k� (�..b?- <br /> � r�le'N •� uN� C(�C=• <br /> ANTNIIM COMACTF6FPERMIT PHONEr O�� <br /> , -, � Y�CS.- 3►�;�o r <br /> C .vt` � �- (.CC_ l�.`�/Y'A9� e�a� <br /> �rr– •�.s . . �� f� - k���c�x+� ct. a.�•� ' �. <br /> ►tCe .�j�ee�� — <br /> CONTR.LIC ER�� �r—e��C SL—.`�`3�i.^�� . . <br /> USE OF BUILDING HEAT SOURCE �ONTRACT PRICE OF WORK <br /> I[1L�f �i'��� �Eleclrk _Gas_Olhor <br /> ���� " 9Mt� ' �� � <br /> WO KDESCRIPTI N J� �>��71°CR-�`C �"^�'S/ � .�.,� 1.,,�{ �� /R�.ICEN���J <br /> y , <br /> �1�1'C�/t��C. /� �1 <br /> '1T1—^Cl�Y__'.___�_ c '_ .. <br /> UMBING MECHANICAL <br /> Np, TYPE OF FlXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tollat _ A1C-air hendlirp units <br /> �� Bnlhlub _ Forcod air systoms <br /> Lavalory(wash bosin) _ Ges piping <br /> Showor _ Weler hoeler <br /> � Kitchen sink 8 disposal _ Gas lireplace <br /> Dishwashor _ Gus rango <br /> Clothes washer _ Clolhes dryor <br /> ^' Woter hoator _ Ranga hood <br /> Sink(servico/bar/mop�etc.) _ Exhausl lan - <br /> . Oackflow preventar _ Hea�pump '� '� ��� <br /> -- Uiinal _ Unit hoator <br /> Odnking Founlain _ Ooilor <br /> Floor droin _ Refdgere�ion <br /> Greasc Irap W°°ds�a�° <br /> Rool drains _ Olhor <br /> Other _— — <br /> CIN OF EVENETT LOCAL SALES TA%CODE IS 7105 � � <br /> I'hcreby ceritily ihat I have road and oxamined tl�is applicntlon nnd know tho semo lo be�rue and correct. All proJfsions'ol laws and <br /> ordinaces govorning thls type of work will bo compliod with whether spocNied horoin or rrol.The qrenting al e permil does nol presume <br /> lo give authorily to iolalo or wncei Ihe p�ovision of any o�hor stale or local law regulating cons�ruclion or Ihe performanco ol <br /> construclion.Th em outhoiizod o ownor al tliis proparty lo pe�form tho work lor which epp�ication Is made and I comply with�he <br /> Stnto Conlr rs Law 18.27 RCyy.:�296200 WAC. <br /> �y" /! d�� - '3-.]cc�7 <br /> �i a ure o Ow orlCoMraclor/ u�li o gont A�° <br /> / <br /> /� <br />