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i,�� i. ; '; � :%APvI <br />--- _ _ � <br />F'E�iIUIIT APPLICATIOI� <br />CfTY OF EVERETT PERMIT SERVICES <br />3.?00 CEDAR STREE7, EVERET7, WA 9820� <br />A25•257•Bp10 — FAX 425•257�BA57 — Hti•�w.evere�twa.org <br />SITC- AUURESS <br />IEGAI� LOT1:0. <br />G[SC <br />��' i2;; � 7 <br />AaPIICATI0N5 ARE ACCEPTED Ffi0h18 AM TO 4 Ph1 ' g y—/� <br />W 6ee�h 51- PaRCEL TAX I.D, 7i P[RI,117 p <br />— _ I YU r 708�001 <br />ELOCN TRACTO�SU601YISION+t <br />vrn.ut ADDRC99 CITV21V PHO k�— <br />_��'► �1 c� r���__ �.rvtR, �i 25 �5 3� � I 3 <br />iEllAt�T NqtdE I CONTACT FON PER1.11I P40NL l� <br />� 2;� �- �'� lifr.t-�IF — <br />' �I� �n�ni P.���'iCL� 'l;l�ltttil : �Oi�i <br />�7fP oNk <br />Cn1 HQA 111q �►1c. �4i5 3r ��cu.� �v�retf qg7t�i ��z�7..5�t���61� <br />f.ONTI�._LICENSE .� bq 5R� <br />L I <br />USE UF DUILDRIG HEAT SOURCE I CONTRACT PRICE OF YJORK <br />_ � Elednc _ Gas __ Otner I <br />5�31 ' <br />\VORK UESCRIP710N <br />InS}ull h.cc��- .�Urn.� <br />PLUMBING <br />N0. TYPL OF FIxTl1qE OR IiFh1 <br />__ ToJel <br />Bathtuti <br />Lav�iory IWaSh �:15in) <br />Showcr <br />_� K�Ichen sink 6 d�5posai <br />_ Dishwasher <br />Clolhes wa;her <br />lValo� hcater <br />_ Slnk (SBP��CB/baUr110�/QIC ) <br />_ Uackflow pru�ontcr <br />— - Urinal <br />Dunk�np Founlaln <br />FIOoi dra n <br />� Greasc Ir,�p <br />Ruoldr�ms <br />^ CU�or <br />N0. � TYPF OF FIX7UIIE UR If EM <br />_ lVC - air �iantlbng �nils <br />. Foiced air ,y,tem; <br />__ Gas pipinp <br />M Water healci <br />_ Gas b�eplacr. <br />__ . Gas ranne <br />cimhes d�yer <br />Rongc huod <br />trhausl lan <br />1__ Hual p:imp <br />llnll heater <br />Bmlr.r <br />� Hclrlge�atiun <br />WOOliS�OVP. <br />Olher <br />CI lY OF EVERETT IOCAL 9oLES TNf COf1E IS �109 <br />I hpreny cenlilv Ihal I have rrad and examineA tnls applicahon antl know Ihe same Io be irue anA coiw��. AU prows��ons of laws and <br />orJmaces poveming 1Ns type ol work �hll bo complled w�lh whother speNGed nerPln or not. Ihe grpnting of a permrt does not presumu <br />to give authmdy m vlolatc or cancel the provision ot any mher slaio or loeai iaw reguWtlnp con,uucUon or Ihe periormence ol <br />GO�Y��UL'bU� That I am uuuronzvd by �ne ownr.r o� �his propeny io podorm Ihe worh ror whicn apphcauon I5 mada and I compiy w�fh the <br />Siaie Coniraclo�s Lnw tti 27 HCW and 29620U WAC <br />. � <br />� _��'I�.� - <br />;ignaW o wncuCopt actoriAwh a� A�7om — Date <br />(� <br />