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P�RMIT APPLICATIt�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-H857 —www.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 f'M <br /> SITE ADDRESS - y �� PARCEL TAX I.D.q P RMIT p <br /> 2(0l W nc, � � �so-yly-oou�- I(o� � �� s�'-27� <br /> LEGAL LOT N0. f3LOCK TRACT <br /> oEsc. ,EE -1-�,p _ �GTI D SEE 71� 0 <br /> OWNER ADDRESS CITY2IP PI10NE <br /> S1J rnve5i-v�,� c�-,�' r�o{�r�ies LLG 117_I�tivhon `�t R�rkla �. °f7�C6 _ <br /> TENANT NAME CONTACT FOR PERMIT PNONE x' �� � <br /> ��.i� plumbiv�P1 April Fil�i��i _ Cy25) �070- (070(0 <br /> CONTRACTOR AODRESS CITY2IP PHONE <br /> � <br /> CONTR.LICENSE k ���� ��C� <br /> USE OF BUILDING HEAT SOI�RCE ONTRACT PRICE OF WORK <br /> EX,S+,,,�j �S q25 � <br /> B �2 _Eloctric _Gas_Othor � <br /> VJORK DESCRIPTION <br /> -Uew �h�e,f i cr �ri;tior5 , vlQ,,,� C�'c�, �.w Yel� . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTI:RE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilo� _ A/C—air handlin�units <br /> Bathlub Forcad air systems <br /> Lavalory(wash basin) _ Gas plpin� <br /> Showor Walor hoalcr <br /> Kitchen sink&disposad _ Gas fireplace <br /> Dishwasher G�srango <br /> Clothes washer Clothes dryr.r <br /> Walor heater R2nc�o hood <br /> Slnk(sorvlcelbar/mo{i'olr.) _ Exhausl lan <br /> Backllow prevenlr.r _ Heal pump <br /> Urinal Unil hoator <br /> Drinkin� Fountai�i _ Doilor <br /> Floor drain Rofrigeration <br /> Groaso Irap _ Woodslove <br /> Roo(drains Other _ <br /> Olhor <br /> CITV OF EV[RETT LOCAL SALES TAX COOE IS�105 <br /> I hereby cerilify Ihat I have read and ezamined�his applicalion and know Iho samo lo bo irue and cortoc�. All provislons ot laws and <br /> ordinaces goveming Ihis typo of work will be complied wilh whother spocified heroin or not.Tho grantin�7 0l a pormil does nol presumn <br /> lo givo aulhorily to violato or cancel lhe provision ol any olher slato or local law rogulaling consWction or ihe peAortnance of <br /> ronslru,tion.That I am,authorized by Iho ownor ol Ihis property to portorm Iho work for which application is mado and I comply wilh the <br /> Slalo G�n tors L� /1f�.27 R a �1 296.200 WAC. <br /> , n� � _ , ' � � d <br /> Signat f wnodCont cror ulh riz d enl ale <br /> , �/� <br />