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PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���-t77�Z <br /> SfTE A�ppESSr� n PAH 'f.t'i.TAX I.D.• ��T! <br /> 113c'L� t'1 .� .�- \�c. 0053'7`l000c,y8�a �.5 <br /> LE �OT NO. BLOCK iNACT di SUBD��ISbN• <br /> DESC. <br /> ss n cmmv <br /> ��t�'Y.:-� 1 .Jc�a..< �r.f:�7 �I�C,'� A,.-��.�� Kd tJcrr.� � W pI <br /> 7EN�Nf NAYE COHfACT FOR PENff PHOpE db.-] -7 LL-75�`I <br /> I �_ <br /> �._��.�:�: C��4�1�.:, Ftd.,..h��..-S �l,��x��\ Jhy E�INLma=c��kr,Z��.-. <<.,.��.,, <br /> �-1 CG C.r� � � 33�y Se s!...�,5 o7nP— <br /> }.�. �.���r,. f��K,,.:2 ,02 <br /> caimuc�s �c3 -358- 3193 <br /> St..,\ G�G � � Sy�a� tiP. c�w -otis•t�s� <br /> USE OF BULDING I HEAT SOUHCE CONTRACT PRICE OF WORK <br /> \3.����.�.�.z - <br /> Eleclric _Gas_Other � �� p c•G <br /> WOPoC DESCFdPTON <br /> �--.,-������ ., ..�y-\c �n\\�.�n.�w�. s,.,,� <br /> \ <br /> PIUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TIPE OF FlXiURE di fiEM <br /> Toilet AIC-air hardling urrits <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) — �WP�^9 <br /> — �ry�� Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Cbthes washer Clotfres dryer <br /> W a�er heater �^9�h� <br /> Sink(service/badmop/etc.) _ Exhaust fan <br /> BackNow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinkirg Fountain _ Boiler <br /> Fioor drain Refigeration <br /> Grease trap . _ Woadstrne <br /> Root drains q�r <br /> Other <br /> qTY OF EVERETT LOCAL SALES TAl(CADE IS 3706 <br /> I hereby ceritily that I have read and examined this application and know the same ta be true ard cortect. All provisiona d lews and <br /> � ordinaces governirg this type of work will be complied wflh whelF�er specified hereirt or no1 The graMing of a permR does not presume <br /> to give authoriry to vidate or cancel ihe provision of any other state or bcal law regulating mnstn�:tion a Me peibrmance of <br /> construction.That I am authorized by the owner of this properry to peAortn Me wurk for which application is made and I compy with the <br /> State CoMractors Law 1827 RGW ard 296200 WAC. <br /> •, 1 9-a� <br /> Signature ot dContractod ut riz ent Date � <br /> � , IZ <br />