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-- , <br /> P'tRMIT APPLICATIUN <br /> CITY OF EVERET'(' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET T, WA 98201 <br /> 425-257-8810 — Fr1X 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.it PERMIT# „ <br /> � <br /> . _ . � �;.,,_i _i, r�'�d���-�'"1�--- � . �� ._��� �i� _��r'��_ �,� �� f ; � - i��"7 — <br /> LrGAL LOTNO. BLOCK TRACT <br /> oesc. � � � � t �l � � � -•��,'�,iht �'�l�-i. �'1C\.x ��c f � <br /> OWNER ADDRE55 CI7YIZIP PHOIJE <br /> E� r . l��i'�� ' ' . .,I - � ��• � ; �'�� � � �. ��; l � ���j��7 l�Ul..��.1-1� �\� L `1 !_`� _ 7��` � � �'��' J <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> a�.��u , � , `� j'� _ c �,.��J�_�-_; ?,-f f , �;, �.� F_b <br /> CJNTRACTOR � i i � ADpRESS � r\i .�� GITY2IP PNONE <br /> CONTR.LICENSE il � <br /> ��.��'� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> —�Electric �Gas Other � `. � �> c C , <br /> �_ 1�� '�. — I <br /> WORK DESCRIPTION L(t/jN U E UF (1 S� A•S'� <br /> , , , l • � ,�1 r , V- ' � �. 1 �.;� � �t ��C�I �_�.A �u.�_:'I���� LIJ �r_--��'—��-=-�-L'vrL, <br /> . i , , . , . � . . - - ., � --�_ _ . _. _. . <br /> i <br /> � . � - �.�_ _ . _. . <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM - NO�I — TYPE OF FI%TURE OR ITEM <br /> Toilot NC -air t�acdling unils <br /> Ba�htuL Parced air syslems <br /> � Lavatory(wash Gasin). �.. 1 �,�"� . i , . . � _ Gas pipinc� <br /> � Shower _ Watcr heater <br /> Kilchensink8disposal ���� i ���.Ai�� l.x�'>�'i• �. 1 _ freplacr, <br /> � Dishwashm . . � � , �._r.t511�,11� Gasr <br /> � Clothes washci � � _ Clolhas dry <br /> _ 1h'alor heater - -- Range h�od '\\ <br /> Sink (scrvicolbadmop/otc.) � � ' � �.p �-. , Exhaust lan � <br /> � BackOow prevenler � _ Heat pump <br /> Urinal _ Unit heater <br /> Drinkinc� FouNain _ Boiler <br /> Flocr drein Rolrigeralion <br /> Grcaso tra�� _ NJoods�ove <br /> -- Roo�drair�s _� O�hor i�.� �:•,�t, � L...��... v.-��� 1; ��_-i�"��,;��� <br /> Olhnr ..___, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceritily Ihal I have read and examined this applicatiun and hnovr lho same to bo true and correcL All provisions ol laws and <br /> ordinaces c�oveming ihis typn of work will bo complied wilh whether specified herein or no�.The granting o(a permil does nol presuma <br /> lo give authorily lo violale or cancel tha provision of any oQier statc:or local law regulalmg construction or Ihe peAormance of <br /> construclion. Thal 1 am aulhorized�y tho owner of�his propehy lo peAorm lhe work lor which application is made and I comply with ine <br /> I Slate Conlrac�orc Law 1o.27 RCW and 296.200 WAC. <br /> i <br /> � � � � �, �. i �l i �,,i � � 1� I t (�. a: <br /> I Signature uf wnedConirac�odAulhorized Agon� Dale / <br /> 1 z <br /> � ____.. ___- _ _..- ---- ---��- ------------ - ----- _.._ <br />