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�pr 24 06 01 : 19p RNOGFR CORP 360 366 5800 p. 2 <br /> —'-------- -, ----- ---- ---- ----�--�,i �� _ <br /> PERNIiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE I', L-VERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.evereHwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NQT ACCEPTED <br /> SI7E AODP.tSS PARCEI TAX I.D.p I PERMIT# <br /> "ll�'�l8 Ca•-��a�` `�����G <br /> l[GAL LOT NO. OIOCK TRACT <br /> DESC. <br /> OWNER ADDRESS GIN21P PHONE <br /> TENANT NAME CONTAf,T FOR PERMIT PI10NE <br /> ���� � G.Q..:-> c�.�� I 7�aR.�� y�..�L� C•����3ioL� gRLv <br /> CONTi'tACTOR ADDR[55 CITYlZIP PHONF <br /> �.-.r'Jc:i�2 CoRC�PrC.�� tc4'3fo '�n�.A-�uo.� ��.�:��. C�0..%.�a.t, ..:.� .�a�a'�4�i <br /> CONTR.LICENSE Y /��J� .,y�4 -gq� <br /> A.�ocacsr�y�oa, �,o -i\���o�o � <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleclric Gas Olher � � �,a� �� <br /> WORK QESCRIPTION �n',a` 0.=.� �'�- o�-:+O 0..:,�, l..a�.p-c.�y l.� <br /> RC:it�O��.�l=n TaC2�=='1 �F �h.S-c.J�j P>u.�:�\�-X�. <br /> PLUMBING MECHANICAL <br /> NO. � TYPE OF FI%TURE OR ITEM NO, TYPE OF FI%TURE OR ITEM <br /> ! Toilet A/C—air handling units <br /> �_ Balhtub _ Forced nir systems <br /> _ lavatory(wash basin) Gas piping <br /> _ Showei Waler healer <br /> __ Kilchen sink 8 disposal Gas firepiace <br /> _ Dishwasher Gasronge <br /> _____ Clolhes washer Clolhes dryer <br /> _ Lnundry iray — Ranpe hood <br /> _ Sink (servicelbar/mop/elc) ^ Exhaust ian <br /> _ DackOow prevenler Noal pump <br /> _ Urinal Unil hcater <br /> _ Drinking Pcunlain — <br /> Floor drain _ Boiler <br /> — Re6iyeration <br /> ._ Greasotnp — <br /> Roof drains —_ W�dstove <br /> Other _ Olhcr <br /> � CITY OF EV[RETT LOCAL SALES 7AX CO�E IS 3105 <br /> I hereby ceritity ihat I have read anJ cx�mined this applica�ion and krnw Ihe same to be Irue and corred. All provisions of laws end <br /> ordinaces goveming�his type of work will be w;:plied with whethcr apecificd herein or not.The granting of a pe�mit does nal presume <br /> lo give authority to vioiale or canccl the provision of any�(her stale or Iocal law regulaling consWctan or the peAormanCe of <br /> construction. That I am autlrorized by Ihe owner of Ihis propeity lo peAnrm ihe work for which application is made and 1 cornply wilh the <br /> Slale Conlraclors Law 18.27 RCW and 29fi.200 WAC. <br /> __�luuux�2 l�c, �r icfa �ti Ca�Q Olfl <br /> Signalure oi Owner/ ontracfor ulhonzed nt Dale <br />