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. •- � a / (p •22'ICJ <br /> \ , <br /> P RMIT APPLICATION <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 ADORESS PARCEL TAX I.D.N PERMIT k <br /> 900� A�r rt Rq. Evercr+ WA,q$2oN 2 $O�II �IOo2oSua0 �IVOC� - 005 <br /> LEGA l0T NO. BLOCK TRACT OR SUBDIVISION fl <br /> DESC. <br /> OWNER ADDRESS CI7Y21P PHONE <br /> !Mukl�}'eo SGhool (�tytci�fi /{�o, 6 sa�5 A;rpo�-�i' Rp. Ev�ad+,4'6'�'i 425-356=11f d <br /> TENANT NAME I CONTACT FOR PERMIT PNONE <br /> E�NIAIL <br /> ,5�..,��"h Frc 5y5��w� ( i�6 5�1= H,•�. E: 7�w Ma � 253-92� 1880 <br /> S M'���'S �36 aT 4`6�t 2ti <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OP WORK <br /> Tec� Sc�pO� Electric _Gas_Other .�� 1, J� <br /> WORK DESCRIPTION b h� '�I ir�t� <br /> Zv�s��.11 iv� o. ���c SPriv�l<<er S�S�� iv� ar� Cfi �s '�-�� ./ <br /> s�-�d-�� �.fi c- G�� F'lww��� P� <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR 17EM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet AIC–air handling units <br /> Bathtub Fo�ced air syslems <br /> Lavatory(wasfi b2sin) _ Gas piping <br /> Shower Water heater <br /> Kkchen sink&disposal _ Gas fireplace ' <br /> Dishwasher Gasrange <br /> Clothes washer _ Clothes dryer <br /> Water heater Range hood <br /> Sink(servicelbadmop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> — �n�� Unit heater <br /> _ Drinking Fountain Boiler <br /> Floor drain Rehigeralion <br /> Grease trap _ Woodstove <br /> Roofdra'_�ns O ' l�5,�.em _ Other <br /> _� Other /'��'C .S� t'1✓1�c�Cr J _ <br /> CITV OF EVERETT LOCAL SALE$7AX CODE IS 7106 <br /> I hereby ceAiy that I have read and examined this application and know the same to be true and corted. All provisior�a of laws and I <br /> ordinances governing ihis rype of work will be complied with whether specified herein or not.The granNog of a pertnit does not Presums , <br /> to give auMoriry to violate or cancel the provision of any other slate or local law regulating construction w Me peAamanoe of <br /> construdion.That I am authorized by the owner of this propeAy to perform the work for which applicatlon is mede and 1 comply wilh lhe <br /> State Contractors Law 18.27 RCVV and OO WAC. �. <br /> -�i� C/�/��O <br /> Si n of Owner/CcntradodAuthonzed AgeM Date (/ <br /> Z <br />