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uF/20/'�n13 GO 11 A�'2:3 P n021on2 <br /> � <br /> P�RMIT�A,�ALICATIOnI ' <br /> CITY C?F EVER�T1" PERMI•T SERVIGES i <br /> I 3200 CEDAR S7REET, EVGRETT, WA 882D1 I <br /> � 425-267-8810 - FAX 425-257-8857-www.evereltwa.org <br /> i _ APPIICATION3 ARE ACCEPTEF�FROM B AM 70 4 PM 6 � �0�,�3_-_� • <br /> I SITE�A�DDO SS ���� �� PARCEL TpJC I.D.it �E�MIT il <br /> .�_ � '___�1.�.-_r'� ,� ' <br /> �[GF� LbT N0. 6L.00K TRACT OR SUODIVISION tl <br /> DESC.I� <br /> �L�__.—.^ — <br /> OWNER A DRESS C IZIP PMONE <br /> (�u�•� /1/j4y�•-s Zo/ Qw�d.r��n .�r�i 9��3 Yzr- 35!7-a�i7 <br /> I TENAIITNAME � , I CONTACTFORPERMIT PMONE � <br /> E-MAIL <br /> E6AYFt7iL`�ON ESS �ti'��f7dRE—l' <br /> , �"1./A,�/w- 5A/�s �� S<��' :360/ G-,�-�7`-�-�- <br /> CONTR.IICENSEv y2�� �� �_ ��� <br /> ����.S50yzk2_ �CYia�-9Pr.0/ <br /> USE CF f3UIL01NG - I HEAT SUURCE - �NTRACT PRICE OF WORK <br /> r i <br /> �s' ,�Eiucvic _Gea_Omor �/ `�3' <br /> WORK DESCRIPTION�/ �/ ' � <br /> �G C/ /Z°Sf' �/CR�aLt J���"J / Jil C�OOY'(.l h� � I <br /> (/ � <br /> —'� PLUMBING MECHANICAL ^ ' <br /> N0. TYPE OF FIXTURE UR IT�M NO. TYPE OF FIXTURE OR ITEM <br /> Toilal ^� � __ A/C-air handling units � <br /> Dau�tub Porced air systems <br /> � Lavatury(wash Ddsin) _ Gas pipinp <br /> W Showor . Waler heatnr <br /> Kitchen sink 8 dispos:,l � Gas 6roplace � <br /> pishwashdr Gae range ' <br /> _ Clothex wasner . Cluthes dryor <br /> Wetar healnr � Renpo hpOtl <br /> SinK;sornco/bar/moD�etcJ �� Exhaualfan <br /> � �ackflow p�eventor � � Heat pump <br /> � Unn;il Unil hqatq( <br /> � pnnking FounL�in � Boilor i <br /> '—' Flonr drain � R6(rigeration <br /> � �reasn I�ap � Woodstove <br /> Roof dreins ' Othar <br /> _ ONer ----__— — I <br /> -- - � <br /> ` CiTY OF EVERETT�OqAI.6ALES TNt COpE IS 7105 � <br /> � I herehy tordify that I havo road and axamined this applieaUon and know tho same M bo tnie and correct. All provisionc ot Inws pnd <br /> ordinac�s govomtng thic type of work wlll be compliod with whatltef,8pocifind harein or nul Tho granihtp o(a parmd does nol presume i <br /> to glvo authority W viol,�te or cancel the crovlsion o(any other stato or lotal law regulapnp coneW CGon or the pertormance of <br /> i «mstructiun. That I am suR�orized Oy lho owner of this proparty lo pertortn thu work for which applicahon Is matle and I wmply with the �, <br /> Stata Coiftraclo:� L 1B. ' RCW and 2d6.200 W�C <br /> �-�r�G��i� �� �i3 -- <br /> S�pnature o OwnedContra��clor�Authorizad Agenl —^��ate� .. <br /> L�f <br /> � _ "'_" ' ___ __��__ . _ __ <br />