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:� <br /> PERMIT APR'LICATlON <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_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS a PARCEL TAX I.D.p PERMIT# I <br /> �// � /��•--r . . G✓.�:.�Uc Or7 L/,i9�'7`�/O/5'Q'� ���� `�, <br /> LEGA LOTNO. LOCK TFiACTORSUBDIVIS10Np I <br /> DESC. I <br /> OWNFR ADDRESS CITY2IP PHONE <br /> �l r^,/ � ,�i,s-r�i 1'Q f ,X?_y��7 .xE�j�f �.r , �I`�/:1�� trr. 91.3 - 9e�s�/ <br /> TENANT NAME I C1ONTACT FOH PERMIT PHONE��j- �j g'-U 7SX ' I <br /> (_!Y� ' ^ � :�� .• G�[�L���A E�-MAII�.�r�nh•:a�Jr..�4JCcsaca �Hr� �, <br /> c I <br /> Ct./Gnr .s+�� S•y�� zs:3- ��',5'—C�%f� I <br /> CONTR.LICENSE# �/;• � ���L,,n�,. ��. <br /> GGlll�is's /�'�1FfL! ,f7D9•/r1 .,�f..�7"L=' T� � 93�{�< <br /> USE OF BUILDING / I — HEAT SOURCE I CON�ACT PRICE OF WORK <br /> ,_��a;rtr-rl�� Elechic _Gas_Other � �rL? <br /> WORK DESCRIPTION <br /> / .,(.. , � /l� <br /> '— 1 ) /"�1'1/7ilY.1 / � /�I �Ie'>i;� _A. F' <br /> .�17:i��1�� lLtt�, r.y Siyi+ <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OFi ITEM <br /> Toilet NC-air handling units <br /> Ba1Mub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Showsr Water heater <br /> _ Kitchen sink 8 disposal _ Gas fireplace � <br /> = Dishw:,sher Gas renge / <br /> Clolhes washer Clolhes dryer /�/ <br /> Water heater Range hood L//;\%��r <br /> _ �ink(service/bar/moplcic.) Exhaust fan <br /> _ Eackflowpmventer Healpump <br /> Urinal Unit heater <br /> Drinking Fountain _ Doi�er i <br /> Floor drain Re(rigeration � <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CIN OF EVEFETT LOCAL SALES TA%CODE IS 3105 <br /> I hereby cerilily Ihat I have read and ezamined this applicatior and know tl�ie same to be true and correct. All provisions ol laws and <br /> ordinaces goveming Ihis type ot work will be complied with whether specified herein or not.The granting ol a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulaling consimction or the performance of <br /> consiruction.That I am authonzed by the owner of this property to pedo:m the work for which appliwtion is m�de and 1 comply with the <br /> State Contractors Law 1 . 7 RCW and 29�.200 WA <br /> ✓" . �� Zf �- <br /> �/ �'�/ / /��' <br /> SignaWre ot edContract r/ u�nzed Agent ate <br /> �Z' <br />