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� : . < < <br /> 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 ACCEPTED FROM 8 AM T01 PM 3��p/Q9 <br /> � <br /> SITE ADDRESS PARCEL 7Af(I.D.11 PER �T „ <br /> 2�11 � es� c/�s?r�e �1on� Ldo'�Wooto2soo , .� ' <br /> IEOA LOT N0. BLOCK TRIICT OR BUBDIVISION R <br /> DESC. <br /> OWNER A DRE CTY21 <br /> TENANTNAME CONTACTFORPERAAIT PMONE 10�-276-99� � <br /> G I 3� �JL� E�AAILTM�QCL� t <br /> �e��A�ct FihP/�vTkT�� P4 60� yz8 Pres�o,�/98oso Zob-68z-6c3L <br /> CONTR.IICENSE�Q t���FP l0 2 L � <br /> USE OF BUILDINf3 I HEAT 80URCE CONTRACT PRICE OF WORK <br /> Dfi�cG /S�rJCr _Eiecmc _Gas__omer flPfoX ,� y��oo _ <br /> WOHK DESCHIPTION p <br /> QC�OCA�c QI`A�ct��i,J6S � Cf0.SSMA�S TO M.tKi /LOow� To�' Now HVA� du�T UroPK <br /> Aa� R¢ � o ��'c 1 1(u► <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM N0. TVPE OF fll(TURE OR IiEM <br /> Tollel A/C—air hendling units <br /> Bathtub Forced air systems <br /> Levalory(wash besin) _ Ges plpinp <br /> Showor Water heator <br /> Kltchon slnk 8 disposel _ Gae lireplace <br /> Dishwashor Ges renge <br /> Clathes washor Clothos dryer <br /> Weter heator Renge hood <br /> Sink(sorvico/bar/mop/atc.) Exhaust lan <br /> Backllow proventer _ Haat pump <br /> Urinal Unit heator <br /> Drinking Founlain _ Bailer <br /> Floor draln Relrlgerelion <br /> Groase trap _ Woodstovo <br /> Rool drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL BALES TA7f CODE IS 9�OS <br /> I hereby caritily Ihat I have raad and examinod this epplication end know the same to ba true end correct. All provisiona of lews end <br /> ordinaces govarning this typa ot wark will bo complied with whether sprcified herein or not.The grenting of a permlt does nol presume <br /> to give eulhority lo violate or cancol the prnvislon af eny o�her slate or locel law reguleting construclion or the perlortnance ol <br /> construction.That I am eutharized by the owner ol Ihls property ta peiform Ihe work lor which application Is made end I comply wlth the <br /> State nira o Law 18.27 RCW end 29G200 WAC. <br /> �11� .�Q�� <br /> 5ignai�d�fUwner onireclor/ ul o ze pent ate <br />