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�ag�v� <br /> I � �" <br /> -t — <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.evereriwa.org IO �Zz—c'c� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT i CREDIT CARDS ARE NOT ACCEPTED <br /> SITE wDDRES3 PARCEL 7AX I.D.� �T� <br /> �Y:cz3 W . C�AS rl�� Qc,ai� � � 7y � (7'C�� <br /> LE�;AL LOT N0. BLOCN TRACT <br /> DEBr <br /> ONMER ADDRE88 CITY/nP PMONE <br /> �061^�G' �[). G�:�c '��� S�a-m� wA `�1��IZ`-� <br /> TENANT NAME �(N� 0 6 CONTACT FOR PERINT PMONE <br /> GB SYSTEMS� �n1C � ��,� -n�M� �r��-y�Z-�.� <br /> croa noweesa emmv vNowe <br /> 7Aoz nIE /7�ST' Ka�roore y1s-y�a -os�y <br /> �o�.��E�sE. G¢sys�.� os�as q�o�s <br /> USE OP BUILDINO HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �uc� /A�SO�c�rril Slce�� I �Electric _Gas_Other 'ISZ�-•Z-' <br /> WORK DESCRIPTION <br /> JAI,`>T��� �-�4T /���iilr ���C ddN��., �,C«c� lN�'r��ION .$l��J_ <br /> PLUMBING MECHANICAL <br /> Np, TVPE OF FI%TURE OR ITEM N�• TYPE OF FI%TURE OR ITEM <br /> Toilet _ A1C-airhandlingunits <br /> BathNb _ Forced air syntems <br /> Lavatory(wash basin) ,_ Gea plping <br /> Shower _ Weter liealer <br /> Kilchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> C�nthes washer _ Cbthes dryer <br /> �traY — Ra"pe hoad <br /> i Sink(servitebarlmop/etc.) _ Eahausllan <br /> Badcflow prevente� � Heal pump <br /> Urinal _ UnR heeter <br /> _ Drinking Fou�tain Boller <br /> Floor drain � ReMgera6on <br /> Grease hap — WO�g�O� <br /> Rooldrains — �� <br /> Other — <br /> CITY OF EVERETT LOCAL SALES 7A1(CODE IS 7706 <br /> I hereby ceritliy that 1 have read and examined this eppliraUon and know the eame to be true and correU. All provisions of laws and <br /> ordinaces goveming this lype of work will be complied with whether spedfied hereln or nol Tl�e Bra�rW of a permtt does not presume <br /> to give authority to violate or cancel the provision ol eny other state or Ixal lew regulatinp construcUon or the parlortnanoe of <br /> con� on.That I am eutho by the owner of this property ro perlorm the work for which apDlicatlon is made end I compty with the <br /> �e Contra 8. 296.200 WAC. <br /> Sig a r on dor u S�t e� <br />