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1 <br /> PERMlT 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 TO 4 PM /D -- a9`� I <br /> SITE ADDFESS PARCEL TAX I.D.N PnERMIT M <br /> � 1� - � <br /> LEGAL LOTNO. BLOCK TRACTORBUBDIVI910NI <br /> DESC. <br /> OWN R ADDRE CITY2IP PMONE <br /> VE21zc�; Lio�.�w,wu�uTi�s <br /> TEHANT NAME I CONTACT FOR PERMIT PHONE <br /> UIe�ZIZLh� J EMAIL <br /> -�o�Tr�E��'lar� Nr�t r�h/��. 2�zo 1�,1« C�i Q�:u (�rzs)z�-a��v <br /> CUL2/,;��OZ?L+T <br /> USE OF BUILDINO I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��A�2 l�.tr1LL_ Eleciric .�Ges__ Other �uj �, � <br /> WORK OESCRI�TION <br /> 81N0 MECHANICAL <br /> N0. TYPE OF fIXTURE OR ITEM N0. TYPE OF FI1(TURE OR ITEM <br /> . __ Toilot A/C—eir hendling unlls <br /> _ _ _ Balhtub ]_ Foiced air eystems <br /> _ _ Lavatory(wesh basin) ( f Gas pipinp <br /> _ _ _ Shower Welor heeter <br /> ___ Kitchon cink 8 dispoeal _� Ges lirepleco <br /> .___ Dishwashor _ Gas range <br /> Clothes weshor Clothos dryer <br /> _ W2tcr hoater Rango hood <br /> Sink(sarvico/b&r/mopiolc.) � Exhausl fen <br /> ___ Backllowproventcr __ Hoa�pump <br /> Uiinal Unit heater <br /> Drinking Fountain Boilor <br /> Floor drnin ___ Rolrigeration <br /> Groaso Irap Woodslove <br /> Rool drnins O�her_, <br /> Olhor . _ . .. _ _. U`�/�� � <br /> -- - - ---- ---- <br /> — --- _ - - ��� ��Iz�lu <br /> CITV OF EVERETT LOCAL SALE9 TAI(CODE IS 7106 <br /> I ncreby corilify�hat I havo raad and ozaminod this application and know�ho same�o be true and correcl. All provisions ol laws and <br /> ordmaces governing Ihis lypn ol work will be compliad with wholhcr spocified homin or no�.The pran�inp ol a perm0 daes not presume <br /> to givo authority to vlolata or cancel Iho provision ol any other state or local law rapulaling constructlon or the pedormance of <br /> cunst u�on.Thet I am authorized by Iha ownar ol Ihis proporty lo perform ihe work for whlch applicatlon Is mede end I Comply with the <br /> StatoC tractorsL �Y/18.�7�CW d'296200WAC. <br /> L � > �L/ �� - �3-ZF' <br /> Si aWre o wnor/ on raclorr ut orize gent ate <br />