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� � <br /> —1 <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 S AM TO I PIA C9��%7 <br /> 81TE ADORE89 PARCEL TAX I.D.• PEpMn� <br /> 2zt 1 W . CAS�Nv zp . 28�4�400zoo9oo - <br /> LEOA LOT N0. eLOCK TRACT OR 9UlDIN&ON/ <br /> DESC. 2g O�- ��(-^IW <br /> 27� <br /> �toi<c. pA1J� t� �(µp�Rc�A I�7a�' �'�-` PL .W. M�AIU�-R.�� �5-?23 -g24 <br /> TENANT NIWE CONTACT fOR PERMIT PMONE�j3 -$52 -I 354- <br /> ��SS��� ��.� I �t��, ��,z �,c�D ���, � • <br /> E AIL n^ <br /> �� ��ccN S�t�1G.� . �� 7! <br /> �5�C-c..tMasa�S. kr� 753 -8s 2-(3S4 <br /> CONTR.UCENSE� �l ev3 Z <br /> ��GtSCc�g3�2- <br /> U8E OF BUII.DINO HEAT SOURCE CONTRACT PRICE OF WORK <br /> �J <br /> ��.X�.2l�-l��Sc _Eleciric _das_Olher �3uv <br /> WORKDEBCRIPTION � � �. FT• �.I.�IJ-- 1llUM� �` S(�c+J Oa 1"�-JN i <br /> V-�ALL 4 SV1l.���.1�� <br /> PLUMBINQ ECHANICAL <br /> Np. TYPE OF FlI(TURE OR ITEM NO. TVPE OF FlIfiVRE ON ITEM <br /> Tollet _ A/C-alr hendting units <br /> Bathtub _ Forced alr eyeteme <br /> Levelory(wesh baefn) _ Gas plping <br /> Shower _ Weterheater <br /> Kitchen sink 8 dispasel _ Gea Ilreplace <br /> D!ahwasher Ges renpe <br /> Clothes washer _ Clothes dryer <br /> Weter heeter Range hood <br /> Sink(service/bar/mop/etc.) _ Exheust fen <br /> Beckllow prevanter _ Heal pump <br /> Urinal _ Unit heater <br /> _ D�Inking Fountaln Boller <br /> Floordrain _ Helriperetlon <br /> Grease trap _ Woadstove <br /> Rool drains _ Other _ <br /> Olher — <br /> Cltt OF EVERETT LOCAL SALES TA%CODE 19 3105 <br /> 1 hereby ceriti(y Ih t I heve read end ezemined Ihia epplicatlon and know the seme to be true and correct. All provislona ol lawa end <br /> ordinaces go(�erm g ihls type ol work wlll be comptied with whather specHied hereln or not.The grentlng ol e parmit doen not presume <br /> to give euthaNty t vlolete or cancel Ihe pravislon ol any other stete or locel lew reguleting constructlon or IM parlortnance of <br /> construcM"on TMa�I em aulharized by the owner ol this proDerty lo peAorm the work lor whlch applicallon is mede and I comply wlth the <br /> Stale Cbnlrs t6r lew iB27 RCW end 296.200 WAC. <br /> �'� 'U 9 <br /> igne ura er/ onlradorl ut o z gent ate � <br /> / � <br />