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( � <br /> PERMIT APPLICATION <br /> CI'FY OF' EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 4:5-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FROM e AM TO 1 PM �/�?�/O5 <br /> E <br /> SITE ADDREI3'9� � Q� PARCEL TAX I.D.R ���' �� <br /> p�I .Z, y�/� t�t.s IA) O !1 U �� W 'Z Sb <br /> LEQA LOT NO. BLOCK TIIACT ON BUSDIVI910N� <br /> DESC. � SE /�' D �(L Le�a� <br /> �5 � �'_ �121 UJ CAs�N� Rp E' V�T �� ��4- '12S-3t�9- i2 <br /> TENANT NAME ��►�T�T���T � y 2S- 3�I - b o i b <br /> ws� ��1 �15 DAJ`1 E�IML bda�y@Tr�w�e 1(,�,� <br /> � �,�T- � .cAw <br /> 1 Ri-N,tEc+.�AN�c.M� , ��� , IB24 �3� f A�E uE 1/ftS- 3ql- bo �b <br /> c°�rrn.ucEr�s�" Sk�i�& BEI.�El1uE wA 9l�00� <br /> USE Of BUILdNO MEAT SOURCE �ONTRACT PRICE OF WORK <br /> I �Eledr� �Oas_Olher � �.4. .Z �� o— <br /> bPFIC ('z - <br /> WOAK DE8CRIPTION <br /> lus�a� Ti�o 2� I�oDF-rar a � U►� ��s ,�o ��+ <br /> PLUMBIN MECHANICAL <br /> ►W. TVPE OF FlI(TURE OR fiEM �• Tr��Fl���� <br /> Tollet A/C—eir haMlinp unlis <br /> Bathtub _ Forced elr systema <br /> _ Lavatory(wash besln) _ Gas plping <br /> Shower _ Wete�heater <br /> Kitchen sink 8 dispoeal _ (3as fireplace <br /> Dishwesher _ �es rerpe <br /> Clothes washe� _ Clothes dryer <br /> Weter hnater _ Range hood <br /> Sink(eervfce/ba�/mop/etc.) _ Ezheust len <br /> Beckllow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ D�inking Fountein Boiler <br /> Floor drain _ Refrlperatlon <br /> Grease trap _ Woodetove <br /> Rool dreins _ Other <br /> piher — <br /> CITY OF EVERETT LOCAL BALEB TAX CODE 18 7106 <br /> I hereby ceritily that I have read end exemined thls epplkatlon end krww Ihe seme to be true and cortect. All provisbna ol lawa end <br /> ordinaces poverning this type ol work wlll be complied wfth whether epecllied hereln or not.The prentinq of e pertnN doec not presume <br /> lo plve euthority to violate or cancel the provislon of any other state or locel law repuletlnp conctrucUon or the peAormance ol <br /> construction.That I em euthorized by the owner of this properry to perlorm Me work lor whkh applk,atlon ia made and 1 comply wflh the <br /> S;a�� tractors Law 1827 end�WAC. / <br /> o? 9 .2u srr <br /> ure o er/ onlrador/ ut o z pent e <br /> � II " <br /> 1 <br />