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PERMIT APPLICATION � _g -��' <br /> CITY OF EVERETT PERMIT SERVICES � ,��;� <br /> 3200 CEQAR STREET, EVERETT,WA 98201 � /���j <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org �,� ; ,C�'(�. (� � <br /> (, <br /> APPUCATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM !' � <br /> SITE ADDRESS PARCEL TAJ(I.D.il ��+MiT N <br /> 3�.aol C.F�h y71ZF-� �4'j I 0 t�'D'aC�'�I a�' (�'`� (� o�< -�U' <br /> IEGAL LOTNO. BLOCK TRACT —--- <br /> °E5� I kN b 2 c�3 <br /> OWNER ADORESS CITY/IIP PHONE <br /> �r'� �,«-�NL-���K-- �o•�'1� 8r-}'J' �V�'R.�1'� 9811�b '�s#'`b ' Irio 1 <br /> TENANTNAME CONIACTFORPERM� PHON[ ��.. <br /> To ��� �T�'CzMIN� I ������� 25�.- 2153 <br /> CONTMCTOR ADORESS CITY2IP PHONE 42� � <br /> G{A��NEY C.oN�'TR�lCfloal luc . �osll Iqn+Av�.�,�, kv�,r�rt- 33a - �14 <br /> CONTRLI.:ENSIE�� /�� 1 - � (�� I� �' QOrj�p <br /> �C.j�{=,IVv�{[ 1�. I o�i•�i <br /> USE OF BUILDINO � HEAT SOURCE CONTRACT PRICE OF WORK <br /> WAFVTl�V1�� _Eledric �Gas_Other �� 2 �.,�'•2 OU <br /> WORK DESCRIPTION <br /> <<���-ri�.uc—�7c►�t �� � 'N£w `�'�—t 37 �,.�, C:M�� �:ct�t,�►�.r.� <br /> , �FlIT�-S- ���" - `'��T" ��-K-!NGZ . <br /> PLUM8ING MECHANICAL <br /> , Nfi. TYPE OF FIXTURE OR ItEM N0. TYPE OF fU(TURE OR ITEM <br /> Toiiel _ A/C–al�handlingunils <br /> Bathlub Forced air systems <br /> Levatory�wash ba;in) _ Gas piping <br /> Showcr Waler healer <br /> Kilchen sink 6 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer _ Clolhes dryer <br /> Laundry lray _ Range hood <br /> Sink(servicebarlmoplelc.) _ Exhausllan <br /> Dackllow preventer _ Hea:pump <br /> Unnal Uni;heatar <br /> Drinking Founlain _ Boiler <br /> Floor drain �tefrigeralion <br /> Grease lrap Woodstova <br /> Roof drains ����_ <br /> Other _ _ <br /> CIiY OF EVEREtt LOCAL SALES TAJ(CODE IS 7105 <br /> 1 hereby centily Ihat I have read end exartdned this appliwlion and knaw the same lo be Yrue end corted. All provisions ol laws and <br /> ordinaces govcrning this lype of work will be wmplied vnlh whelher specified herein or nol.Tha granting of a permit dces nal Dresume <br /> lo give euthority lu violale or wn I lhe pre sion ol eny other slste or lowl iaw regulating conslrucUon or the perlortnancn of <br /> construdion.Th am eulhori d by o er o'Ihis propeAy lo pedarm Ihe work lor which applicalion Is rnade end I comply with Ihe <br /> Slate onVacl Law 18 7 a 2�00 Y�AC. <br /> � � <br /> Sign ure OvmedContradodAulhom_e Agent te <br />, ��1 <br />