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-- -------- �-,� 9 c, , � o�i�, <br /> P�RMIT APPLICATIt,��l <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U 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 /> SIT ADDR SS � PARCEL TAX I.D.M PERMIT fF <br /> ��0 � �l/ C<<S;,,c k c���l �1��-02Z <br /> LEGAL LOT NO. — flLOCK— TRACT OR SUBDIVISION p <br /> UESC. <br /> OW1i�R ADDRESS CITYIZIP PHONE <br /> � (��t�Ct/ �C1!"�� � '%�:>I /.rt ��- • l <br /> TENANT NAME CONTACT FOR PERMIT PHONE L�,'� fi3c.� ��3c) <br /> C:[_l(�'C! �ir � �( //)y'C. r ��5, �C1C)� •�i/) E-MNLf:�V•P•�2vr./A•�<i�Is»1�.._�_ i•.�t <br /> Z,`O-RYitA�Tb�— �� �T� 7 <br /> f� � - tV:' J%/� �S�A �Il�a�� �J1r' ;L' < 7 �i <br /> ��I,In,Il�lr7lU.7 . �� n..� . . i i;� i,5��/qve X . � , <br /> CONTR. LIGENSE p, <br /> ,�����,v i-'t�,5�JS 1�:T <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I �� �/ �� <br /> 1.1� I ��' �C�(5C' �/�! �--�C e �Eloddc/�_Gas_Olher ��L<k� �� <br /> —�-�------_-- <br /> WORKDESCRIPTION ��' Li..C� /�'C'. �.c' /1ir."j-��ce� G�d;l i t- :��fi� ti �r'.� �si� ,_ f_�,- t�✓ �� t' <br /> / � '`� <br /> / 1� �K ' �(.t,<. i ��� i � !1�%.lr 'j t+�� �('/�1;/ ��'!iC't � C/�F' JuI�� /-n.i f-r/ <br /> i:� r . � �-� ,� 1, ,, ,!, > , , � -, �� ./_�.fi, F:�,� <br /> -- _--- _ -- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIX7UR[OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _._—_ _.. _.._. _ _. _. . . . ____ ' .___— — _— <br /> 1��Jet i� A�C - air hanAliny units <br /> 13alhlul� 3 Forced alr syslems <br /> ..- - La�riWry�wash bosin) � Gas piping <br /> Shnwer _ Wa�er hr.���er <br /> �--- Kilchen snik A dispos�l __ Gas �ireplace <br /> � Dishwashur ___ Gas ranqr <br /> Clu!I�r.s washur _ .. Cb�hes dryer <br /> - -- W alcn c�alcr Range hood <br /> -- -- Sin4 �servir.o/b;uhnuphAc.� �_ Exhausllan <br /> [�:i�klluw pmw�nl„i Hoal pump <br /> Urinal _� Unil healcr <br /> � Orinkiny Founlain ___ Boller <br /> Floor drain Rolrigeration <br /> Grc�asc trap _ Woodsbve <br /> Rool draiins ___ Olhe� _._ <br /> ---- Olhor __ — � <br /> — - - — <br /> � --------------- ---- - --- —�---------- <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS N05 <br /> I he�reUy a�rilify Ihal I havr, read anA examined�his appBr.ation anA know ihe same b be true and correct. All provislons o�laws and <br /> orAmaces quvc�rniny this�ype o�worF wdl bi�compliod wi�h whether speciliod horein ur noL Tho granling ef a permit does not presume <br /> to give aidliority lu violate or cancel Iha provision o�any olher slato or local law regulating cons�ru^lion or ihe perlormanco of <br /> conslruc�ion. Thal I am aulhoriLeil by Ihe uwner ol lhis properly�o perlorm�he work�or which application is made end I comply with lh9 <br /> Slate Cunlractors 1:iw 1H.27 hCW anJ 2N62U0 WAC. . <br /> %L i`'�'`��`1 <br /> Signalur OwnedConlracWriAulhorired A�onl D21e <br /> J1 <br />