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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- FPJ( 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAl(I.D.A PERMIT N <br /> 5�v / �� �/,4�z_ aoya �o - so � -oo ,-a� pasvg -oo� <br /> LEGA LOTNO. BLOCK TCRACT // / <br /> DESC. � �. �j� � G v E�-t�f L.c+ ... .� �d S �/,CS 7' <br /> OWNER / ADDRES9 � 0 ��j CITY2IP Pli NE Z��y_ Fg�' <br /> �Z4� / �/N �� �/Z. � T '"^-/ .�i �� C�!/t'.t f '7� �it/.0 'r"/fj�0(p <br /> ITENANT N E � CONiACT FOR PERMIT PFiONE <br /> �-� .�, � .� � �� � -s�,�� - yz7 - �s� -��� <br />� CONTRACTOR ADDRE98 CITY2IP PHONE <br /> CONTR.L,^EN5E N � � ^ �j �� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I _Eleclric _Gas_Other I�j�,v„o �K��(��Opp <br /> WORK DE3CRIPTION <br /> / / / <br /> �� �' •' � � /� L �� �5-�iw �� �O�� � � �/�'/�F� G,� <br /> f7�.r� ,C.'Y ., �c. �-'c � /� !/Fc t �i� �.n�.J -+cii�,--t �5 / / <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—alr handling unils <br /> Bathtub Forced alr systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Wator healer <br /> _ Kitchen sink 8 disposal _ Ges fireplace � � <br /> Dishwasher Gasrange <br /> _ Clolhes washor ���� Clothes dryer <br /> Laundrytrey �� Range hood <br /> Sink(servlce/bar/mop/etc.) Ezhausl fan <br /> Backllow preventer Heel pump' <br /> Urinal Unit healer <br /> Drinking Fountain Boller ��. <br /> Floor drain ��.;dgeralion '�� <br /> Grease trap Noodslove ', <br /> Roof drains Olhor <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS J10S <br /> I hereby ceriti(y Ihal I have raad and examined Ihis applicatlon and know ihe same lo be lrue and correcl. All provislona o(laws and <br /> ordinaces governing this type ot work will be complled with whelher speclFled hereln or not.The grantlnp of a permit does not preaume <br /> lo give outhority to violate or cancel the provlsion of any olher slate or loc�l law reputedng conslrucUon or the performance of <br /> construclion.Thal I am authorized by the owner o(lhis pmperty lo pei Form the wark for which appllcaUon Is made end I comply wllh the <br /> Slale Conlractors Law 18.27 RCW and 296.200 WAC. <br /> gnature o rrner! ontractod uthorize genl ate <br />