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�rRMIT APPLICATIvN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.evereriwa.org <br /> pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRES$����� =�'�1� -' PARCEL TAX I.D.It PERMIT;� <br /> � " 31 w�-rMt�� �4�E. a �s i - t c �:� l h C 6�'��� - oc�4 <br /> LEGA LOT NO. BLOCK TRACT OR SUBDNISION M <br /> DESC. I � � � �-D � <br /> OWNER ADDRESS CITY2IP PFiONE <br /> S�NurARTz R�rJ�i-P «903 I 82No �v� 5� M���, WA `� �'Z7 <br /> TENANT NAME 7 S �j- 3��- �� CONTACT FOR PERMIT PFiONE � - 35' - /G[)` C7 <br /> �V7S�Lt� S�PcToN I QVSSELL- � Loti T(�Ksc�2) e�a�� � , c•�=>ta��v�rt¢�a2 rC <br /> � <br /> ! PIIORE <br /> �� C�-rcr-1 l-�cr-t�`� 13 �-v �1� 2GTM+ Sr, �3�r�.�v�.?�, t�A y800 <br /> CONTR.L�CENSEN L����"1"GI-1�`��fSQ�W J;//4D) S`�iT� I� � ZG �c�'�' S(�, - (�c3 <br /> --r/ <br /> USE OF BUILDING *4- HE SOURC'_ CONTRACi PRICE OF WORK <br /> �;4 ( qLl Gh�UgIL������ _ElecMc _Gas_Olher � � �J � G O �� <br /> 1 f <br /> WORKDESCRIPTION ��L L� .r���T ��fP�o����.T rr �iST/�/C� <br /> I�l �n/C(Z ��:L�t'ic' 12 � <br /> GC:TDcc�2 c c6�ci?ir� KEp.'li,c' C�.�r2-9 yf. �y�Tiat, C�j- �3� ����1/�,�1� <br /> j�c t � -c,'1' .UOl,�`, t t/� S�c-vr��rY; i{/G C//�� � ' VS� " <br /> PLUMBING MECHANICAL <br /> Np. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Da�htub ///111 Forced air systems <br /> = Lavalory(wash basin) % � / 1 / Gas piping <br /> Shower S L LI,C�D _ Water healer <br /> Kitchen sinM.3 disposal �� ``uC i Gas fireplaco <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater Range hood <br /> Sink(serviceibarlmop/elc.) _ Exhausl fan <br /> Back(!ow preventer _ Heal pump <br /> Urinal Unil heater <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodslove <br /> Roof drains Other <br /> Olher _ , <br /> CITY OF EVERETT LOCAL SALES TA%CODE�5 7705 <br /> I hereby cerilily that I have read and examined this applicalion and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type ot work will be complied with whether specitied herein or noL The granling of a permil does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the periormance of <br /> conslruction.That I am aulhorized by lhe owner ol this property lo perform the work(or which application is made and I comply with lhe <br /> Slale Contredors Law 78.27 RCW and 29G.200 WAC. <br /> -�--�- �� � � / i 1-i 'Lao� <br /> Signalure of OwnertContract orized Agent Date � <br /> L <br />