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� �RMIT APPLICATIUN
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, [VERETT, WA 98201
<br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org
<br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ;� , � .�
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<br /> SITE ADORESS i� . PARCEL TAX I.D.M PERMIT p
<br /> ' I"1'�3 ilk� PL. S�F. 6sq6 U(X�001_���as ---__I L>(�lo'�=�=�2�-
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<br /> LE,l�L LOT NO. BLOCK TRACT Ok SUBDIVISION k
<br /> f>ES(: � GrjOp- OO
<br /> OWNER --- - ---�----- -- --- - - AODRESS ---- �— CITY2IP��---�-PNONE '��It 'L/S
<br /> $�11 Qjerk�i�e- -- ���OS IN9�� �� S�E. ..S�,o6am,s1 ������96 `` ' �
<br /> TENANT AME CONiACT FOR PERMIT PHONE �06 _[�BC�" a0j y
<br /> N P �AN ItiUI,�C alrn,�,J �u.,s�rMt,� �.7c ,�
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<br /> E•MAIL �
<br /> /Inth an I Co�,�fiw�� i�„ � s�,t,,—���C���— --�r�— —�aaaE -y
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<br /> CONTR LICENSEp�, �v G),k -753 ��r�(� (ti,�d � �f
<br /> ,,�.P[N C S 986 3 E ��� � �
<br /> U n�I ' ( C LDING.. �. .. � .�� . . ... _..--�I --� -- _FI�,�:IHEAT SOURCE rllher------� I�� UU(�,T PRICE OF WORK ,I'
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<br /> WORKDESCRIPTION MJ�,�� 3 p,�,,. iVew �a�- U nn� + � ` i" 7 '.h�l�J-ih-- I
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<br /> FLUMBING MtCHAN�CAL I
<br /> NO. 7VPC Of FlXTURF OR R[M NO. I TYPE Of Fl%TURE OR ITEM -- ��
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<br /> I��d��l .—. ___ . ._ . .. � n'C air h�indGnq unil•�
<br /> H;dh1uL f!ur.ud air sysle�n���
<br /> — L;rv�tlu�y (wash Iri�in) Gas pipin,y �I
<br /> i _ Shnwcr ----- Wnlen c�rdnr
<br /> _ Kilchon sinV 8 dis�x�sal Gas fu�+pl��i�.0 �
<br /> i Dishwash�rr _ Gas ran{�e 'I
<br /> Clo�hes washer Clulhes dryur ,
<br /> Walar healer Range hood '
<br /> _ Slnk (survlcelbar�nwp/nlc.) Exhausl len i
<br /> I _ [3ac411nw preven�er Heal pump ,
<br /> _. Urin;d UNI hcolcr
<br /> _ Diinking fuunl�nn n��iler i
<br /> Flour dr;iin F.olri��u�liun
<br /> _ Grc:�su Ir:ip _---� Woudslove
<br /> Rool dr�ins Otha!
<br /> -- O�hor — ----_.__--�--
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<br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 _ �I
<br /> I hi�rr.by cenli�y Ih��I have read end o��mm�d�his applica0on and know the same lu bo Irue and corred All provislons of laws anA I
<br /> urA�n;u;i�s{�uv�eminy ihis lype ol work will be cumplii�d with whelher spoclfir�A harein or not.Tho granliny ul a parmlt Aues nol prosumc
<br /> ta yivv;�ulhunty lo violalo ur crmcvl iho pruvision of any uther slale o�loc�l Inw regulaliny conslructiun or ihe p�rlormance ol '�
<br /> �onslruciiun. Thal I am aulhon:ed Ihe owner ul�his propeAy lo perlorm Ihe work for which appllcelion is made and 1 comply wilh Ihu
<br />� Sla�e C ntiad�irs I nw 1H-.7 RCW inJ:9fi200 WAC.
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<br /> SignaWre u OwneoConlrarW Aullicxi�ed Agonl Dalo '� ��.
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