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PE MIT APPLICATIOIV� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, INA 98201 '�{� <br /> 425-25?-8810- FAX 425-257-�85'-www.everettwa.org C 9G��•/ <br /> APPLiCATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITE ADaRESS q PARCE TAX I.D.N PERMIT N <br /> � �J G. 4.¢ 9 i4,�u� C�oy 3� Fl�� 300�J� <br /> �kP� Gve �k���1 <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION N � � , <br /> DESC. <br /> OWNER ` ADDRESS CITY2IP PH`aS_ <br /> I'Yl,kP �n� I�n�, q.,�JFf Vo�{'KI Ir W`'� (3�4ti. � Wr, �go I I 3�4 3.S 5��_ <br /> TENANTNANE �— I CONTACTFORPE IT PHONE <br /> 1'v►7�.���e�( �r.�� <br /> e-Ma� u��.,�.0=�•c�r, <br /> �A�� �o — <br /> CONTR.LICENSE N <br /> USE OF UUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> � �{x A — �Eleclric __Ga�__Other I 3�1 Q��� `�� <br /> WORK DESCRIPTION <br /> �v� ah�.( re m�-� I C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OP.ITEM <br /> Toilot NC–air handling u,�its <br /> 8athtub Forcod air syslums <br /> Lavalory(wash basin) Gas piping <br /> Shower Wa�or haator <br /> Ki�chen sink 8 disposal Gas lireplar.o <br /> Dishwasher Gasrange <br /> Clothes washer Clothos dryer <br /> Vrator hoalcr _ Ranc�e hood <br /> Sink(sorvlco/barlmop�olc.) Exhaust fan <br /> Backllow preven�er Hea�pump <br /> Urinal Unil haaler <br /> Drinkin� Founlain Boiler <br /> f lour drain Re(rigeralion <br /> Grease trap Woodstove <br /> Rool drains Olher <br /> Other <br /> CITY OF EVERETT LOCNL BALES TAX CODE IS 3105 <br /> I hornby ceriUfy that I havo read and eramined this application and know Ihe samo to be We and correcl. AII provisions ot laws and � <br /> ordinaces govominy lhis type of woik will be compliod with whether specilied herein or noL The granting o(a permit does not presume <br /> to givc authori;y to violalo or cancel the provision of any olhor stata or local law regulaling construction or Ihe peAormance ol <br /> construclion.Thal 1 am a horized by the owner of this property lo perform the work for which applicalion Is made and I comp�y with Ihe <br /> State Coniraclon Law � 7 RCW and'196.200 WAC. <br /> + ^ [ /, -� <br /> ` ��Si naluro ol O�vne onlraclur/Author¢ed A�ent 6 �a� Dale" <br />