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n <br /> , `� ,�`t PE�MIT APPUCATION <br /> . � CITY OF EVERETT PERMIT SERVICES <br /> ,� 3200 CEDAR STREET, EVERETT, WA 98201 �-�g�� <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org i <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM <br /> SITE ADDRESS PARCEL TAX I.D.X PF�A IT,N <br /> IIBa-I S.R. 9q Ev�RE�C WA q8� °eH4A9-aov-o19-09� oo�MiA9-eal-o�3-� /�/Jj,�/��f'C,C� 7 <br /> , � oov4o9- oo�-Oai'o1 \"..%��f (, c� <br /> LEGA LOT NO. B OCK jL�ACT <br /> DESC. �� � <br /> Vjp�1e ADDRE55 CINfLP PHO E <br /> �t3a�f`�� Mwrin�Qry�(1� 102o AJBRqn1D�VD, �,LEn)DAce,c.p C8�8 z4�/- 8237 <br /> bTk F�oOR 9,zo� e,�+ 18N <br /> [d�TkCT- S?EUEIJ 1-loe](�ERI� <br /> TENANT NAME ��N�A�TF�OR��PERMI��T' (yZS� 6iONE <br /> OR�G��URI, f�RDHOoSE �7Riu-. � Lleo <br /> Jt+n�re T�e&,r.ilR <br /> CONTRACTOR ADDRESS CITY2IP PNONE <br /> L � �- J��E.• �� �� f=�-lo a�-..- <: , F'-�. . <br /> CONTR.LICENSE Y <br /> USE OF BUILD�NG HEAT SOURCE CONTRACT PRICE OF WORK <br /> ����� µ��b U� y�TA�� _Eiedric _Gas_Other . �qpp� I <br /> . <br /> WORK DESCRIPTION <br /> SITE DCVGWPML�NT f'OR M1 RES'tAtiRfWT R�D 5£PARfl?L RC'fp�l- �UI/„�ING� �nN6lRUG.TGN <br /> oF A NGw REs-rpuRaN�r. SFP/i CJS D� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> !v Lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> �_ Kitchen sink&disposal Gas fireplace �^/ <br /> I Di�washer _ renge (� <br /> Clothes washer _ Cloth dryer i' I <br /> Laundry trsy Range ho �„/ % „ � \ <br /> —� Sink (service/baHmoplelc.) � Exhaustfan �, ly�' fJV'I <br /> Backflow preventer Heat pump ����_� � \ � <br /> 2 Unnal Unit healer '\,,, ,`J <br /> � Drinking Fountain _ Boiler ��4�� <br /> � � Floordrain � _ Refrigeration <br /> Z Grease trap _ Woodstove � <br /> � Roof drains _ Other <br /> Other <br /> I <br /> iCITY OF EVERETT IOCAL SALES TAl(CODE IS 7105 <br /> I hereby ceritiy ihat I have read and examined this application and know the same to be irue an•i coned. AII provisions of laws and I <br /> � ordinaces goveming this type of work will be complied with whether specified herein or nol The granting of a permit does not presume <br /> j to give authority to violate or cancel the provision of any other state or locaf law regulating construc6:on or the performance of <br /> I consirudion.That I am authorized by ihe owner of this property to perform ihe work tor which application is made and I compty with the <br /> State ontractors Law 1827 RCW and 296200 WAC <br /> I � <br /> FRCI6EIT t ND PRCMITECT3 ZI27�(� <br /> Si ture of wnedC rador/Aulhonzed Agent Date <br /> �Iz <br />