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---� � <br /> PERMIT APPLICATION <br /> I 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 -DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS ��S EvFJ�iT� PARCEL TAX I.D.N PERMIT/ <br /> l040�qi.R.Po�c wA`1 Sw B1A q Z$aA2.3-eoPv_1 co D O - <br /> LEGA lOTNO. BLOCK TRACT <br /> oesc. q 5� .o <br /> ONMER ADDRE39 CITYIZIP PHONE � <br /> �LTf4 �Q�SECZ'-LLG �i�'� f��L. S.v�. ��So�SDs� �7�-'�Z'L.-3�5� . <br /> TENANT NAME CONTACT FOR PERMIT VNONE <br /> �-A�/��VC6 }10RoW�TZ- �'G�'!ab �'1Arv..�� ,4�-6��-6� SXT.IIg <br /> CONTRACTOR Ncs( ��,F.GnT6� G-"(' ADDRESS cmmv vHo <br /> CONTR LICENSE t / J/��C/�+L T��1 CJ \_S�/U✓I��S � /��//7� <br /> l �v I I✓/ �G � <br /> USE OF BUILDING NEAt SOURCE I CONT T PRICE OF WORR . <br /> C3F�-FC-G— _Electric �Gas Other � 'OO�boo ' <br /> WORK DF:&CRIPTION <br /> -�No ZNT�S��e u,'Al�-s/r.l�=nri�2 �A!'-Tx7�N s/PFl���/F� FsNis+,cs <br /> PLUMBING MECHANICAL <br /> NO. TVPE OP FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet fVC—air handling units <br /> Bathtub Forced air aystems <br /> Lavatory(wash basin) Gas piping � <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Cbthes dryer <br /> Laurnlry troy Range hood <br /> Sink(servicelbadmop/etc.) Ezhaust fan i <br /> Backflow preventer Heat pump <br /> Urinal Unil heater <br /> Dnnking FounWin � Boikr <br /> Flaor drein Refngeration <br /> Grease trep Woodstove <br /> Roof dreins � Other <br /> Other <br /> � <br /> . CITY OP EVERETT LOCAL 8ALE9 7AX CODE IS SYOE <br /> I hereby ceritiry that 1 have read and examined this application an0 know lhe same to be true and corteC. All proviaions at laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a permit does nol presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construcGon or the perfortnance of <br /> construction.That I am authorized by the owner of this propeRy to peAortn the woAc tor which application is made antl I comply with the <br /> State Contrectors Law 1827 RCW and 296200 WAC. <br /> rar✓� Hr^^�r- a� 13/04 <br /> S+gnature o ned ontrector uthorrzed gent ate �/L <br />