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I I <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.everettwa.org <br /> ll77 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y�-a �� <br /> SITE ADDRESS C� PARCEL TAX I.D./ PERMIT i <br /> - c �,��� � ooy C �� - zl <br /> LEGA LOT NO. BIOCK TRACT OR SUBDMSION/ <br /> DESC. - LO � 2 2 � EVE�// S tJB/�/V/S/ON O � � <br /> OWNER ADORE33 CITY2IP PHONE <br /> n � n ( �)sy.s-ao�y <br /> /Cii�VE/�/ [.liNlTS �(�/s2�Jt.TioAJ /S// /lJ. ?SE�� SEA%/LfG�f�gq/03 <br /> TENANTNAME I CONTACTFORPERMIT PHONEt+.Zs- ZSZ' �12u� <br /> �— <br /> IN�Y;�rttr��, JX" ��,,� .. ��f�/r:f.>I��c�r�� ,•7 <br /> �'/b b��� �C� �l E�NIAIL C' �'l.irie���. � . ��.h <br /> �4v�N N � n�� S C.v��i/�V�'.TilvL��.SI/ �J SS�S I �RllL6`�f+v3 ?pL�.S`IS-zd y <br /> CONTR.LICENSE N <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> O ._ � I _Electric �as /� Olhor <br /> /1 <br /> WORKDESCRIPTION -._ ]�j AS � C � <br /> -U N � � � % soFs <br /> . _ G - <br /> —�� PLUMBIN� MECHANICAL <br /> N0. iYPE OF FI%TURE OR I'��=M NO. TYPE OF FIXTURE OR ITEN� <br /> � Toilel A/C-alr handling unils <br /> �y'Z_ Balhtub � Forcod air systems <br /> __ _ Lavatory(wash basin) Gas piping <br /> Shower � Walor heator <br /> � Kilchen sink 8 disposal Z Gas flreplace <br /> Dishwashor Ges range <br /> � Clothes washor � Clolhes dryar <br /> � Waler heater Range hood <br /> Sink(service/bar/moplolc.) � Extiaust(an <br /> 8acktlow prevonler Heat pump <br /> Urinal Unll heater <br /> Drinking Founlaln Boiler <br /> _ Floor draln � Re(rigeraUon <br />' Grease Irap Woodstove <br /> Rool drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 7105 <br /> I heroby ceritiy thal 1 havo read and examinod this epp8cation and know the same to be We and correct. /UI pruvisions o(laws and <br /> ordinaces governing Ihis typo of work wil�be compliod wilh whelhnr specified hereln or not.The granting of a permif does not presume <br /> to give aulhorily to violate or cancol lhe provislon of any olher state or bcal law rogulatlng constructlon or lhe perfortnance of <br /> constructlon.That I am aulhorized by the owner of this property lo peAortn Ihe work lor which appNcation Is made and I c.�mply wilh the <br /> Stalo Contraclors La 18.27 RCW and 296.200 WAC. <br /> �J ��'�7� �7 <br /> �i�Sig a ure of odConlraclor Agent Date �I� <br />