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- ----- , - � <br /> P�RMIT APPLICATIC�N <br /> CiTY OF EVERET7 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 �`�y `O � <br /> S�TE ADDRESS PARCEL TAX I.D.p P RMIT# <br /> �",�,,� �.I.ct��ao tz,p 2gn q�oo'�04"7 cx� ��%�1- C�/_'� <br /> LEGAL LOTNO. BLOCK-1 TRACT <br /> DESC. �j�E Tc � oF y.-, <br /> OW E - � ADDRESS CITY2IP PHONE <br /> c�.�t�Jo t�j �c,. G f v <br /> C.00Pe'2S"f87N / G�G MGMTCa. I�7Z0 H�OJG1NFv�oiJ D2 W1U{GILTBa ��a' . <br /> TENANTNAME CONTAGTFORPERMIT PHONE <br /> �.00oI-� �L,3Z. {�tW �I���o^L Zofo.�ls,1213 <br /> CONTRACTOR ADDRESS CITV2IP PHONE <br /> �� <br /> CONTR. LICENSE d <br /> USE OF BUILDIN HEAT SOURCE CONTRACT PRICE OF WORK <br /> �vRcT�c.�`(�-7•11� * `��uouS ^c^ <br /> �p � �� �u� _Eleclric �Gas_Olhor ��J�-'�`� <br /> WORK DESCRIPTION 5�������p�./ M��a� p�m0���� � ���Z..t��1 <br /> Wi°�� ��.1�,-ctat-t�T�oa v�. �irula,.� �- a�ip+��+-t- � T'S(�E� cook..�..i.,e- <br /> Noc>�D w/ EX+I�qusT' sFFapr �, Mior�-uP n�rL. oa r�o�'. pl-v�++c���� �( <br /> pTl�6Y�S —� . <br /> PLUMBING . ECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> � Toilot �4STI�J(e A/C-air handlip unHf <br /> � �alhlub forcad air syslems <br /> � Lavalory(wash basin) Elc15n��c. � � Gas piping <br /> Showcr � _� a�er hoalcr <br /> Ki!�hen sinY.d disposal G. fireplace <br /> Dish�.v�shcr 1 �C Gas nge z. (3�m,,gr` <br /> Clolhesl�ashcr Clolhes ryer <br /> _� Waler healtu, l 1� Range ho 'T�(Pc�• I <br /> � Sink(service 13n�/ �o Ic.) _ Ezhausl lan <br /> _ 6ackllow prevonl..\ _ Hcat pump <br /> Urinal Uni�healer <br /> Drinking Founlain �� Boiler <br /> _�C Floordrain '3 �vp�¢ycc� Z�S__ Rolrigoralion (�6"r1 - � or..v..� <br /> �_ Groase trap �Z,� R , Woodslovo <br /> Rooldrahis 1 � Olher ��7� _ ' <br /> _1 ou,er�',� Pa,msw�� w,�-r�S�Nic. � -� _8a����.en.i_ <br /> -- �-�tzbpGl�'t�1s.'+�_5��••k-��Ttun, �(µ� ( �L M�ve�z_ . <br /> I .j. CoAS Gtu�l... <br /> CIN OF EVERET�LOCAL SALES TAX CODE IS J105 <br /> I haoby cerilify ihal I have read and examined ihis applicalion and know the same lo bo Irue and correcL All provisions of laws and <br /> ordinacos miny this lype ol work will be cumphed with whelher specilied herein or nol.The qranting ol a permil doos nol presumo <br /> to give a Ihor y lo violale or cancel Uie provision ol any olher state or local law ree�ulatin9 consiruction or ihe perlormance of <br /> conslru tion hal I am authorized by Ihe owner ol lhis property to oeitorm�he work for which application is made and I comply wilh lhe <br /> SI� n C nlr clors Law 18.27 RCW and 296.'100 WAC. <br /> � ,�_— � 0 5 '/a <br /> Si e ir.dContraclodAuthorizad Agent Dat <br /> I�4.L1 + G>O <br />