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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.everetlwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 0 AM TO 4 PM <br /> ,SLITE ADDRESS PI-ARCEL TAI(I.D.M �j [P�FR/M^R MZ <br /> -10�� R�c-;E� A��. �l�)YJI `\�Lf�� 70� /> (��'J ' �� <br /> LEGAL LOTNO. BLOCK � TRACT <br /> DESC. '�� WGyTR�r�G.r <br /> �,_po A <br /> p ADD EE5 � CITY2IP PH 8 <br /> L��'�ZJ�J <br /> �NRTN'RN ���PN�Y �IS3�� A�� RVC l.VI:RC� li� Z(o3S <br /> TENANT NAME CONTACi FOR PERMIT PN�E <br /> • �c���F�C\\HN SCFIN�Y I � �oNi�C�\HN STAN�-�' �`125� 25y-21e35 <br /> CONTRACTOR ADDRE88 CITY2IP PHONE <br /> CONTR.LICEN8E M �)��� <br /> CJ <br /> USE OF BUILDING — HEAT SOURCE I G�)NTRACT PRICE UF WORK <br /> .'.(F\CE Electric ✓Gas_Other �2� ��7 <br /> WORKDESCRIPTION � WPu� �t�+s�+��= + ��'�0��-" // ��L k �' X (v� 01 <br /> YPJ�rnE �X�ST�N6 cb�o-REYL. � �/ c/D <br /> �•fyaac_ CaGST�N6 C'Rnm"O WAu-s. ` < /�n. �7 <br /> •�{C'CTRo�YLa%\�'1N6�c�(�CNR.�' Cf�N�ST`J <br /> , F�w�lSNEO <br /> SNaT w E - �tWi,EN ��K��Ni;n WFaC�oro ot BF6EmENT 7 PKo(���0 �o� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITiM NO. TYPE OF FIXTURE Olt lTEM <br /> Toilet A1C-eU handling units <br /> Ba1hWb Fcrced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 dis{wsal _ Ggs fireplace <br /> Dishwasher _ Gasrange <br /> Clolhes washer _ Clolhes dryer <br /> Waler heator Ranpe twod <br /> Sink(service/bar/mop/elc.) _ Exhausllan <br /> BackOow preventer __ Heat pump <br /> Urinal _ Unit healer <br /> Drinking Founlain _ Boiler <br /> Floor drain Rnlrigeration <br /> Grease irap Woodstove <br /> Rooi dralns Olher_ <br /> Olher _ — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerilify thal I have read and examined lhis application and know Ihe same lo be true and cortect. i.11 provisions ot laws end <br /> ordinacos governing lhis type ol work will be compliod wllh whether specified hereln or not.The granUng of a permit doea not presume <br /> to give authorily to violate or cancel Ihe provision of any other state or local law regulaUng constructlon or the perfortnance of <br /> conslruction.That I am authorized by Ihe owner of lhis property lo peAorm the work(or which appllcaUon is mede and I comply wlth the <br /> State Cantractors Law 18.27 296.200 WAC. <br /> " -- 3 �y v�o <br /> �� � <br /> Signatura o Ownor/ reetorlAuLL ' Agent ate <br /> i <br /> I <br />