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P� .tMIT APPLICATIG. . <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 /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4�M 6 �a S�/� <br /> SITE ADDRESS PARCEL TAX I.D.# /PJERMIT 8 <br /> �$3Z- '(�j MOR-C UOS 2 S(�ZO -7007 IJ OU�o ' 0� � <br /> D SC. L`l � I 8 ��GK� � TRACT Oj SUBDIVISION M ��T � T <br /> C.. <br /> OWNER ADDRESS CITV121P PHONE <br /> �A �!- UE��G� � 3 i,r�l�N �(2( � f� (i,AC. fkiF �it'.LL�rJ�(�+� �✓4 <br /> TENANT NAME � CONTACT FOR PERMIT PHONE ��ZS'-,j f�y �`}'+�.3 <br /> N ✓'-�� S E•MAIL L��� CON � <br /> Lc�/��� " ^i <br /> 5 ���IS i- ,M �/ <br /> COHTR.LICENSEM y�u ��9fL �� S� TL"i '3vl - <br /> ��°'v��A a iK 387 o G ,�.�cor� W.4 S'3 S3 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK , <br /> ��r�C1r _[leciric �Gas_Olher ,� Q � v <br /> i <br /> WORK DESCRIPTION <br /> I�IC� {��o-�„�/�/ � u.��owS'� ���7rz�� t2�{�, l�(�tiJ Co?.u � c� i <br /> ,S� D �r�(7 <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Tode� NC-air handling un��s <br /> Balhlub Forced air systems <br /> Lavalory (wash basin) _ Gas piping <br /> Shower Water heater <br /> Ki�chen sink&disposal Gas fi�eplace <br /> Dishwasher Gas range <br /> Clothes washer Clolhes dryer � <br /> Water hea�er Range hood <br /> Sink (service/badmop/ctc) 6xhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unil healer <br /> Drinking Founlain Boiler <br /> Floor drain f2efrige�aiion <br /> Grease Irap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3705 <br /> I hereby ceAi(y lhat I have read and examined Ihis application and kncw�he same to 6e irue and corred. All provisions o1 laws and <br /> ordmances yoveming�his lype o(work will be complied with whether speci(ed herem or noL The granting ol a pertnit does nol presume <br /> �o give authority lo viola�e r cancel�he provision of any o�her sta�e or local law regulating construction or the pertormance ot <br /> consiruclion. That I am au orized by Ihe owner of this preperty lo perfonn ihe�vork for which apphcation is made and I comply with ihe <br /> S�ate Contractors Law 18. � RCW and 29�200 WAC. � <br /> � + � i <br /> I Signat�ire of OwnedContra toi/�ulhoiized Agenl D te �/ �I <br /> � ------��- � <br />