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`/ . ____- <br /> PERMIT APPLICATIUN .� i -, , � <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADOREuS PARCEL TAIf I.D,p PERMIT N <br /> i5o� ��u,�.�ra. ��Er oo4�t�z� t400 I � C�9id - 003 <br /> LEGAL LOT N0. BLOC� TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PNONE <br /> t�Av�'�t-� t'Lr�C� 2'12: cat.t'..t�' AVE.�hU� 2�0 �Y�2ET'T' �82�� <br /> GNll�b FG7�/c�,4.."'i L�1-iT�'tZ <br /> TENANTNAME C:ONTACTFORPERMIT PHONE �cj• �jy,��.08�oa <br /> �e,..�.[�u �AG� 'b�Yit,l �YI.G� e�ni� de.vin�bnhar�h. <br /> �� <br /> NO�G� NaT"����'� <br /> CONTR.LICENSE N <br /> OL/1 i'��;�7 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��' occU�ANcY —�- _ � <br /> ���� ���,� Elodric Gas_Olher � ��_��r�:��— <br /> WORK DESCRIPTION <br /> �L—M�l— � �x�-rn-�. -rwo �rr�r ��c� x�ui�,� Ci-7, 12��-.1) <br /> PLUMBING MECHANICAI. <br /> NO. TYPE OF fIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilol A/C—air handling unils <br /> Bath�ub Forcod air syslems <br /> Lavalory(wash basin) Gas piping <br /> � Shower VJalar hnator <br /> Kilchon sink 8 dis{�sal Gas liroplaco <br /> Dishwasher Gas ranga <br /> Clothes washer Clothes dryor <br /> Walcn c�alcr Ranga hood <br /> Sink(scrvice/bar/mop/otc.) Fxhausl lan <br /> Oackllow proventcr Hoat pump <br /> Urinal Unil hoalar <br /> Drinking Fountain Boller <br /> Floor drain Refrigeration <br /> Greaso Irap Woodstovu <br /> Roof drains Other <br /> Othor <br /> CITY OF EVERETT LOCAL SALES TIU(CODE IS�105 <br /> I horoby corilify that I havo read and ozaminod Ihis npplicalion and know tho same to be trua and correct. All provisions o(laws and <br /> ordinaces�weming this typo of work will bo compliod wilh whelher s{wciliod horein or not.The granting o(a pormit doos nol presume <br /> to c�ive aulhority to violato c-cancol the provision of any olher state or local law regulating conslruclion ar Ihe perlormar�ce ol <br /> conslruction. Thal I am authorized by Iho ownor of this property to p9r(orm lho work lor which application is made and I comply wilh Ihe <br /> State Conlraclors Law 18.27 RCW and 29 00 WAC. <br /> / <br /> ��„�� I - ( -'D� <br /> Sign�Wre ol Ow udCon rac Ac�enl Date I <br /> /` <br />