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, <br /> PERMIT APPLICATIUN <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 /> APPI.ICAT10N5 ARE ACCEP7E� FROM B AM TO 4 PM __ �O — 5--�� <br /> 2�32HEg�-i�� PNE q82oi � D�y3��t�3302�00 M M��z - �°y <br /> LEG� LO'i NO. OLOCK TRAf,T OR SUBDIVISION p I <br /> p95Q _ <br /> OWNER A�OPE55 CITYly1P PNONE <br /> Rog�R� 2�3Z R�A'K�2 � �g'82o1 u25•15y•7�to5 <br /> TENANT NAMC � COHTAC7 FOA P�RMi7 PHONE y2 5 •2SZ� I p�+} <br /> Pa�yo� ►�ca��►�y fi•MAILPa�u�ra, ��, � <br /> -�� ------�msA �r N • a 0. <br /> �.vu�a� F�A.'��� y�lo Cvec�vee.v� C-�t- 2 �25 •2sz � co <br /> CONT .UCEN9E M �� 1•��I #� q8 2 D �J I �Z�� <br /> V�` <br /> US[OF BUILDING HtAT SOURCE CONTRACT PRiCE OF WORK <br /> �'OM E —Fi�,�:�,�� ✓;,�_._.oin�� ,� 3023 • Gb <br /> WORK D[SCRIPTION � <br /> �� �'} L1� TUQ U�P g���b 5as �.w�ace <br /> PLUMCiING MECHANICAL " <br /> NO. TYFE OF FIXTURE OR IT6M HO. I 1YPE OR FIX7U�7E OR ITEM <br /> Tn�lot � NC—alr hanAlmp units � <br /> Bathtub � Furced air sy:s�erns <br /> I = Lavaloiy (wash b�sin) = Ons plping <br /> Showor W�lor h0olcr <br /> i Kilehen clnk 8 tlinporol Gac fireplaee <br /> O�c��wachvr � Gns rnngn <br /> � Clollio,waEhnr _. Clnlhes dryer <br /> Wator hoaler _ Ranga hood <br /> Sink(sarvic0lbar/mOp�ott.) _ GMhau7l(0n <br /> Oackflow Drovonlor �iC�t pump <br /> Urinal Unil hCate� <br /> Drinking fountd�n G011pf <br /> Flonrclraln � Refngeraqun <br /> I _� GrCUSu Irpp-----------�Y-- = Wui)tlsl0vo <br /> Roof df2'm� OIhOr <br /> Olh�t <br /> I � —_ —��-- — <br /> � ------- <br /> '' CITY OF fVERI;TT�OCAL SALES TA7C CODE IS 7105 <br /> �� I heieby certlify th�l I hove re3d Bnd ez�mined lhls appllcaUnn and know the same to be tr�o 0nd currect. All provi6lons of lawy tlnd <br /> �I ord�naces p�vorn��.np Ih�e Iype of work wlll be r.emplir.tl wnN wholhnr speellind heraln o�nol.The yrTntin�of a permil does nol prewme <br /> �� io givo sutlier�ry to vioiato or eaf hu provislon of any olhnr stalo nr loeai law rogulating construcUon or lho periermanco ol <br /> Consinietion. 7ha1 I af:f hQFzed y tha owno �� �e propnrty to pgrform tho wo�k for whlth nppUcation is mado and I Comply with t�e <br /> SC�to ontrarinry I K'7; RC and 29G. 0`NAC. <br /> ,� 1 U� D S�OeJ <br /> $ig'�.r u i IC riAulhori� � d Ag l �t�lo <br /> I <br /> t , '�+� . � . -, .�,�t.i ;Ui :IJCi.�i 8?:��� 6i�02-S�-�INIJ <br />