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P�RMIT APPLICATIVN , � <br /> CITY OF EVERETT PERMIT SERVICES LI- `�l� � <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 TO 1 PM <br /> SITE ADDRESS � PARCEL TN(I.D.N PER IT N <br /> � �l �fi� ���'� 9 � /J� <br /> LEGAL LOT NC. BLOCK TRACT OR SUBUIVISION M <br /> DESC. <br /> O � �' � / �DR���6 'V h// �V2� �PHGE.G ��/�/�Y/ <br /> TE�NT NAME C CT FOR P�EJg MIT PHONE as — � <br /> '����('/J./l ��C 17A�I� I l.�✓�G�K �j"� E�h1AI UKi'//V/ ![P�'i `� <br /> �"�'�- Ab�iIES`� 27�—�� <br /> 5��� <br /> CONTR.LICENSE N <br /> USE OF BUILDING HEAT SOURCE ONTRACT PRICE OF WORK <br /> o Electric�Gas_Olher <br /> vvV f <br /> G CUU �c.�uSv — <br /> WORK DES RIP710N <br /> /�r1,VIl.Fi)'1� �/�'I�J/`��t/�m��'�`— <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilel NC—air handling units <br /> Balhtub Forced air systems <br /> � Lavatory(wash basin) _ Gas piping <br /> S`�ower Water hoater <br /> = Kitchon sink 8 disposal _ Gas lireplace <br /> Dishwashor Gas range <br /> Clolhes washor Clolhes dryor <br /> � Waler hoaler _ Range hood <br /> Sink(sorvico/barlmop/olc.) _ Exhaust fan <br /> Backllow prevenlor _ Heal pump <br /> �_ Urinal _ Unil haater <br /> Drinking Fountain _ Boller <br /> � Floor drain _ Refrigoration <br /> Grcasr.trap _ Woodstove <br /> Roof dralns _ Olher <br /> Olhor _ <br /> — — -- <br /> CITY OF EV[RETT LOCAL SALE9 TAX CODE 19 7705 <br /> I hereby ce�itily that I havo road and ezaminod Ihis appiication and know ihe same lo be lrue and corcocl. All provlsA+is ol laws end <br /> ordinaccrs govurninp this typo ol work will bo complied with whelher specifiod herain or rwt.The granting o(a permil does not presume <br /> to give aulhority to violalo or cancol tho provision ol any other slale or local law regulaling con5lruction or lhe performance ol <br /> conslruclion. Thal I am orized by Iho owner of Ihis property lo pertorm Ihe work for which eppHcalion is made end I comply wilh lhe <br /> Stalo Co ors aw i�H � 00 WAC. � <br /> SI a uro of OwnedContrac�odAuthorized Agonl ��� <br /> '/� <br />