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PE��MIT APPLICATIOtv <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �,(�, <br /> 425-257-8810- FAX 42F-257-8857-www.everettwa.org � -�� ` <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C � �� y � � <br /> SITE ADDRESS PARCEL TAX I.D.N P RMIT# <br /> �,� �.I.���o tz�o 28oq�2oo�o4-7cx� / �.�/1 -/�� <br /> LEGAL LOTNO. BLOCN TRACT <br /> D[SC. �j�� 'E � oFZ <br /> OW E ADDRESS CITY2IP PHONE <br /> C��itNo 2p A�55r�G. fao <br /> C.00�e,S'T81� / G�G MS.Mt" � �0720_ ("��ORAN$ylE� 02 W1vKILTBb �Vsa •- <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> 'Q.�jpp�o �23'Z F�u. 1✓����o'L Zo6.11s.121'�j <br /> CONTRACTOR AGDRESS CITY2IP PHONE <br /> ��� <br /> CONTR.LICENSE 11 <br /> USE OF BUILDIN HEAT SOURCE I �CONTRACT PRICE OF WORK <br /> COR�r�aQ�( �-7•Il� '1- �!l+a..�ous —I 1�J�9�.�U <br /> �vop �y �k- PIuS� _[lor.tric _�Gas_OOmr 1— <br /> WORKDESCRIPTIONs.��U�r�p?�, M��o� p��v��,C,�� � P����,J <br /> u/�i i�.l�i�nni-t.4Ttoti1 e� K.iru�L�+ �. 4�ip+h�-r , 'T�I'E� cook.�..�.,�- <br /> F�'� W/ '�X1�4usT s►�FA-p[- � W1ar�-up u,�rt_ oi•l 200�. pl-u+nt3��.IV Y3Y <br /> OTl+�Yth — - <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR I7EM N0. TYPE OF FIXTURE OR ITEM <br /> �_ Toilol E'KISTI�fIe _ NC-air handling unils <br /> �alhlub Forced air syslems <br /> �,^j� Lavatory(wash basin) �cIST7�c. � � Gas piping <br /> � Shower � � Water heater <br /> �� Kilchon sink 8 disposal Gas fireplace <br /> --- Dishwnsher 1 �C Gas r.mc�c 2 (3�ca,,eQ, <br /> Clotl�,os washer Clolhes Aryer .. <br /> �. Water hea�cr ( 1 �S_ Ran�e hood '�P�- � ' <br /> x ;ink(seniceibarl io �Ic.) _ Erhaust fan <br /> Dar.Allow prevenler Meat pump <br /> Urmal � Unit hesler� <br /> Drinking Fountain �oilcr <br /> _ CZ Floor drain '3. �,lo i¢..E� 2�S_ Refric�oralion R6f�cM - i..� o r.+v..� <br /> �_ Grea;e irap Za R Woodslovc <br /> Rool drains 1 � Olher__F��Z <br /> 1 _ Other��La.s��P�ltJk� m6"T�S��IIL � —ac- -�AY�raL o�¢s.�-- <br /> _. �_�OMQ(iRT1��S�r-+k-�UTl.i1� 7SNy 1 � _�S�CP'fi <br /> I .�c, foAS G2l�L.. <br /> CITY OF EVERETT LOCAL SALES?AX CODE IS J105 <br /> I herr.by ceritily ihat I havc road anA ezamined Ihis applicalion and know Ihe samo to be lrue and wrroct. All provisions of laws and <br /> ordinacos .ming�his lype o(work will bo complled wilh whr,lher specilied heiein or noL Tho granling ol a parmil does not prusumo <br /> to givA a Ihor� y lo violate or cancel lhe provision ol any olhor stale or local law regulaling consWc�ion or the�ieAormance of <br /> constru lion hat I am au�horizc�d by the ownor of ihis proper(y;o p�rtnrm the work lor which applicalion is made and I eomply wilh ihe <br /> St e C �nlr ctors Law 10.27 RCW and 29fi,20U N'AC. <br /> fs.�4�a.�o�gns.Z �Sz��� <br /> Si e iedCuntraclorlAulhorized Ayant Dal / I <br /> L I <br /> � <br /> lS4.zl + �o <br />