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r- fi � <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.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.• RM • <br /> ira6 c1r�r►.�...-F- f�.,e, 9grr�r �►4�3a r��9� /� d3 -DD <br /> LEGJ1 LOT NO. BLOp( 7RACT OR 8UlDIV190N• <br /> DESC. �9 �a� 3zf0�'OO 1 OW �3 �'�. <br /> ,��r1r►ti��,ari`� aq�l �.�i�''6� s� <.,�...��I y�a� . <br /> cart�ct Foa vea�tr��we 4.�ro�E �Z3"'.1�/- �87a <br /> �����/�:y ��/PK�r7 f I ��I v/� -X a{� �/�if#IAIL L.�.fi/ �t T�" e�+�X. <br /> -c� rrn�— �a.,-• <br /> �f25- Z3�— ys`io . <br /> ca�,n.ucense. L-�ck.�T�914�� . <br /> USE OF BUILdN(7 HEAT SOURCE CONTlIACT PRICE OF WORK <br /> S.�.R. .,�eiecuic ,�ca,_ane� DO . � <br /> WORK DESCPIP�IQN c �Qt►� c+P �z 3 t-:.c d- d�,..,,� � �; 1i�� <br /> kil�...v lv....d �,�..,� a- b��*�-r.�. . s1;�ror1� rG-� ��+.�.���� d��+ <br /> � "� �;..de...+s , so.� <br /> n1��„i a� <�jec��oi�',�,�hs�ids�m��i 't(11a�h„►A,.-M.b� i.ild- �C�- o�-.i{ ,s�.�� <br /> o..�i li �15 . 'v.� w(ide.x e,��.s d�1TS�ak�Ta. l.�a�.a t �t� . Wf�ac` (de.�o. <br /> PL MBI E ANI <br /> N0. I TYPE OF FlXTURE OR ITEM N0. 7YPE aF FlXiLRE OR IiHA <br /> ✓ Toilet NC—air hardMnp units <br /> �' datMub Forced ei�systems <br /> Levalay(wash besin) — G�s dP�^0 <br /> — g�q�� Weterheater <br /> Ki�hen sink 8 disposal _ Ges fireplace <br /> Diahwasher Ges rerqe <br /> Clothes washer Clolhes dryer <br /> Water heater 7 Ranpe hood <br /> Sink(aervice/barlmop/etc.) _ Exhaust lan <br /> Backllow preventer _ Fieat pump <br /> Urinel Unit heeter <br /> Drinkinp Fountain _ Boiler <br /> Flao�drein Relriperelion <br /> Greese trap _ Waodstove <br /> Rool dreins aher <br /> Olher <br /> CRV Of EVEHEIT LOCAI.8ALE8 TAI(OOOE 18�106 <br /> I hereby ceriGly that�have read and examined this applicatian and hnow the same lo be tnie and conect. All provislona ol laws and <br /> ordinaces goveming ihis type ol work will be complied wfth wheN�er specilied Mrein or nW.The prantinp ol e permfl does not prosume <br /> to pive euthority lo violate a cencel the provlsion ol any otMr olate a local law repulatinp conslniction or the peAamence ol <br /> construction.T�et 1 em auttarized by the owner ol lhis property to perform Ihe wort�lor whfch epplicatian la made and I comply with Ihe <br /> ,:tato Contr rs Law 1827 RC and 298200 WAC. <br /> ���iYic� �- �.2 ' �/� <br /> L � r o er ntracta ihonz�e gant �ate <br /> L— <br />