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P�.r?!','iIT APPLICATIG�� <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 /> � �� - � o <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS /� n PARCEL TAX I.D,p P RMIT N <br /> �Z7.7 (..clSCcxc�P_ ���p-�---�CTa. <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRE39 CI?Y IP PH NE — <br /> M � k�= �Da� ;s � zZ7 C�,s«;aP< <�K.�- i�zc>;; ',�zS-Z��o�6•'dl, <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> CONTRACTOR J ADDRES9 CITY2�P PHONE <br /> Jt.lSt K:c�� U�t��lr��' srf•J�cc3 L[C' Sn���Or1:e1. <br /> CONTR.LICENSEN Z0�1 �. (nf Cr�af` l�Sc� �• c• '/7.S '.�,j✓"`��1 <br /> r<<s�RaA?�sJs P issz , o <br /> USE OF BUILOING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I��•^�r /Qc:v_���o�{ X Eleclric _Gas !� Olher Un�nn;un(t.J"��/Y7�� `.% <br /> WORKDE3CRIPTION ��n< h,�rneP �r,stuKc�, Q,i�m,�,�r.�Qelrt<t i75FaiF.'� �''� I�Y�n9�eCr^'� '���cG <br /> b�.n��' wnl! (r.�rr;��-)� c.hAl �cof. S;x r`x�Mft�•r� nr.r..Q �e�:�CPN1<Kf'.as w-cl(«5 f�rF <br /> ��"l�••iIi.�ncC��cl;h.Q tn.^�ircj �+t���.�r�c+�s • �41' tIY, �ni"rr;u�nF fa�rnY�e����kc+�RaMn. Nr.0 rn�'<rrpr ��u.�l� <br /> �w.i�fn�[IMf4 7iA�3�,�J^r}=. (,I��r1f.wQCIn�L.IC.'I;'P•��[Iltit W. f� 17:"�C� :cn�'K�, �� <br /> '^� r � � N�, .i�ta �,;u !�� <br /> PLUMBING MECHAN CAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FDCTURE OR ITEM <br /> Tollet AIC—alr hendling unila <br /> _ Bathtub Forced eir eyatems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 dinposal Gas flreplace <br /> Dishwasher Gea range <br /> Clolhes washer Clothea dryer <br /> Laundry tray Range hood <br /> Sink(service/badmopretc.) E�tauat fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boller <br /> Floor drain Refrfgeretlon <br /> Grease trep Woodsto e - <br /> _ Roof drains _IL ier_ :r � <br /> e <br /> Other <br /> CITY OF EVERETf LOCAL 9ALE3 SAX COOE IS�70� <br /> II hereby ceritily that I have read and examir,ed thia applicatlon and know the same to be We and cortect. All proviaiona ot laws end <br /> Iordinacas governing this type of work will be complied with whether specifled herein or not.The grenting of a pertnit does not preeume <br /> , to give authonry to violate or cancel the provislon of eny other sfate or local law reguleUng constructlon or the performanca of <br /> construction.That I am aulhorized by lhe owner of thla property to perform the work tor whlch appllcatlon la made and I comply wllh the <br /> IState Contractors La 18. CW and/2 �200 WAC. <br /> ig�a/ r ����' f'7`� � !( �'�i <br /> '-f'i�,��3'1 /�1/y • 4� r�Y�YJ ��3 ' <br /> e� wnen ontrp ori utA nzed Agent a-6 te— <br /> � � <br /> i <br />