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PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTEO FROM B AM TO 4 PM <br /> >ITE AODRESS PARCEL TAX I.D.N PERMIT# �7 <br /> Z G -I L ��S ' � n� 1^,�. i��,'J� : l <br /> LEGAL LOT NO. ALOCK TRACT OR SUBDIVISION It <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> /J3 �. ��a�fi �-Ifl. IO(�SS N�.y�{t Sf . � 300 �sl�rvvt WJ� • �(@�y — <br /> TENANTNAME -�lifi� nl�Inf" �I�/�II I IF� CONTACTFORPERMIT PHON '36O 630 6 300 <br /> %}/�� ' �'J �' cl 'v � MUY10 ��PZ E�MPJL <br /> �� t�— <br /> CONTR.LICENSE p ��? <br /> �7/C�I J� <br /> USE OF BUILOING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ���"�� (' _Elac�ric _Gas_Uthcr <br /> � ��'� � � <br /> WORK DESCRIPTION <br /> bv� (� 0 �SLM19G�� S�UIGC, C .� G1� Ci'h1��C F . <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FI%TURL OR ITEN NO. TYPE OF FIXTURE OR ITEM <br /> Toilcl A/C-air handling unGs <br /> BathWb __ Forced air syslems <br /> Lava�ory(wash basm� _ Gas piping <br /> Showr,r __ Waterhealor <br /> Kilchen sink 8 disposnl _ Gas fireplaco <br /> Dishwashnr __ Gas ran�e <br /> Clolhes washer ___ Clothos dryer <br /> Waler heal,�r _ Range hood <br /> Sink(senicelbarlmoplelcJ _ Ezhaust fan <br /> Backllow preventer __ Heat{vmp <br /> Urinal _ Unit heater <br /> Drinkinc�Fc�ntai� _ Boiler <br /> Floor drain _ Refrigeralion <br /> Grease trap __ Woodslove <br /> Run(drains __ O�her <br /> Olher ___ — <br /> CITV OF EVERETT LOCAL SALES TFJ(CODE IS�105 <br /> II horoby coritily Ihat I havo reac and examinod this applicahon and know the same to bo lrue and cortecL Atl provisions of laws and <br /> ordinaces yoveming this typo of work wilt be complied wilh whelher spocifiod herein ur noL The granling ol e pormil does not presume <br /> to give authority lo violatr, or cancel the p�ovision uf any othor state or local law rogulaling consfruction or lhe performance of <br /> construr,lion. Tha�I am authorized by lhe owner of this property lo perlorm lhe work tor which epplicalion is made and I comply wilh Ihe <br /> Stale Conlraclors Law 1827 RCW and 2�J6200 NAC. <br /> I <br /> Signatum of OwncrlConlrar.ludAulhorized Ac�ent Dale I <br /> /�t. <br />