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! ' <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 GEDAR STREET, EVERETT. WA 98201 <br /> 425-257-8810-- FAX 425-257-8857-www.everettwa.org � <br /> / i��� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM l ` � � <br /> .J1 <br /> SITE ADDRESS �% PARCEL TAX I.D.N PERMIT R'�� <br /> L �%/1�v / � oo y <br /> LEGA LOi NO. BLOCK TRACT OR SUBDINSION N � � <br /> DESC. — LD � ,2 Z � EVE/�/%.StJt�/�/ViS�ON 'O <br /> OWNER ADDRE33 CITY2IP P�N��S`J.S'aV�7 <br /> /Ci9✓E/✓ L l NCTS �R1/S2✓[:Tia,tJ /S/� /1J. iSE�i� ,ScA%/LEL/�/��/03 <br /> TENANT NAME I CONT T FOR PERMIT PHONE 4 ZS� j�Z � �7 2 u� <br /> 1 In��'I�:�c�iu.--� Ix,=',�C,v_, <br /> 1� Ilry�r�lr�� .�r.�r-„���5 n � <br /> 'ljclh��v� R �'t'� E-MA1L �� .� <br /> / �4V�N .N �nl C> S G.v9�/�'V�,Ti�LH) �.S// � . `55f�1S� .�/�/T�E`J�O i ?OC)S'`�S —2CJ�y <br /> CONTR.LICENSE N <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> D _ '?� _Eleclric �as /� Other <br /> /1 <br /> WORKDESCRIPTION �j AS � C � �� <br /> U N �� i Z .\> C.._ <br /> F'LUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � Toilel fVC—afr ha�dlirg units <br /> ���� �athlub Forcod air systems <br /> � Lavatory(wash basln) � Gas piping <br /> Shower Waler healer <br /> � Kilchon sink 8 disposal Z Gas fireplace <br /> Dishwashar Gas range <br /> � Ctothes washer � Clothes dryer <br /> � Waler healer Range hood <br /> Sink(service/bar/mup/alc.) � E�aust lan <br /> Back(low prevonler _ Heat pump <br /> Urinal _ Unit heater �i <br /> Drinking Fountain Boiler <br /> _ Floor drain �� � Rolrigeralion <br /> Graasulrep Woodstove <br /> Roof dreins Olher <br /> Olher <br /> CITY OF EVERE7T LOCAL SALES TAl(CODE IS 7105 <br /> I horeby corilily thal I havo road and euamined lhis applicalion and know Ihe same to be Wo and correcl. Atl proWsions ot laws and <br /> ordinaces governing Ihis lype ot work will be compliad wilh wlielhor specified herein or not.The granling al a pertnil does nol prosume <br /> to give aulhorily to violala or cancol Iha provision o1 any olhor stale or local iaw regulatlng conslrucllon or lhe pertortnance o( <br /> construclion.That I am aulhorized by the owner of this properly lo oeAorm ihe work lor which applica6on is made and I comply wilh the <br /> Slate Conlraclors La 18.27 RCW and 296.200 WAC. <br /> /i-o7_ U � <br /> �i Si�o of odContraclo/o/�rt»t42ed Agent Dalo 7 � <br />