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--- -- ---------- ------- — ---- y � � 3� <br /> PERM��' APPLICATION <br /> ClTY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT.WA 98201 <br /> 425-257-8810- f=AX 42r257•8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROIN 8 AM TO 4 PM � �� � �� <br /> SITE ADDRESS AARCEL TAX I.D.• PERMR R <br /> 77 � 5 E C�si �v 2�� 0�393 DPA I oc� �C' v��$ c,� <br /> LF.GAI LO7M0. BLOCK TRAGT09SI1BDNI510 t <br /> ���� � p �o D- ve;v�t ��rl� �'L1�`1— <br /> owr�n AODRESS rn oer 5(� 1155 <br /> ��>1�+��- Qr���rSYI ✓l�r' 7�is E c�isina d�c� Ever1-SF '�A 9s� <br /> 7ENAHT NAME I COHTACT F�O(�R PERYT PMONE '�p,D � ( S <br /> D1� 11�1 `��Q,IW, 1 E�MNL f1�C�/e�6.�C1G�.CD(Y1 <br /> S�'�--CIT9'�3P—�� <br /> �� � e��hs�'t-Lc o�n IyUZ 134"'�oK. SE SulSham�bh L�,Iq 9�Ya-qo 3�o5i8 i�s1' <br /> COHTR.LK:ENSE I R�l.��I G} I7GY�:J <br /> USE OF BUILDING I HEAT SOURCE I CONTHACT PRI(:E Of WORX <br /> �Glecinc Gas Olhei <br /> WORK DESCRIVTION <br /> Ir1S�tal\ rjo..c- s�v��, d re.luca,+-a, Q.X�S�"IiC� OU'fOIDOr ��i,1C� <br /> v <br /> PLUMBING MECHANiCAL <br /> NO. TYPE OF FlXTl1RE OR ITEM NO. TVPE OF FlXTURE OR ITEM <br /> Tndet A,C -au handlinp unAs <br /> 8811d�ib Porccd eu sy5lr,ms <br /> Lavatory iwa�n iknm) Gas VPin� <br /> Shower Water heater <br /> Kddien s�N,g disposal Gas Irteplace <br /> Uishwasher Cr�s ranpe <br /> Clnthes washcr Clothes drycr <br /> Watei healei Hanpe hc�d <br /> � x $inh Iservice,'Wrmqietc 1 Eahaust lan <br /> ❑adclbw Prevcider Heal purnp <br /> Unnal UnA heater <br /> Dnnk�np Fountam fioder <br /> Flooi diain Pefnueiahm <br /> G�ease Ir.y.� Woods�ove <br /> Hool dmins (Ahc� <br /> � Othei ('�(,�"(l� Ct'� . <br /> d:. <<<t <br /> CITV OF CVERETT LOGAL SALES TA%CODE IS 3105 <br /> I her qy c r Ay Ihat I hnve read and ezammed Uus appi�cation and know the same lo be true mid conei,y. All pmwsions ol laws and <br /> ordi aters vr.rnmp Vus ty{�ol woik wdl be r,onq�hed wdh wl:clher s��;d�ed herem or not.The p�anlinp ol a�r;nnd dces not presume <br /> tn 'au rdy to vidate or cina,�l the pro�s�on ol any otlier state or bcal law repulaUnp constructon or the peAormance ot <br /> coi r c � That�am aulhonzed by 4�e on•ner ot ihu property to pedarn ihe work tor whch apphcation is made and I wmpy Mnih the <br /> Sia r dors Law 1627 RCW and 29G.200 WAG. <br /> � � 3u 0�' <br /> S�q�a ner.' onirador�Authonzed A{�ent Uale <br />