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P�RMIT APPLICATI�inl <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.evereUwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO+PM �'I ` �7`� 1 <br /> SITE ADDRESS PARCEL TAX I.D.A PERMIT N <br /> I �� Cl.esl-w,�- - ��9�3z�o�� �� (_. _ S <br /> LEGA LOTNO. BLOCK TRACTORSUBDIVISIONN <br /> DESC. <br /> OWNER�I 1 'u+r'\ �� ADD��QI �I� �SI�J CI�NU^Ao�HO� P �l�(D� _ <br /> � <br /> TENANTNAME CONTACTFORPERMIT PMONE <br /> ' L ',.,� -, u O <br /> �tc...� Z•y� T'�NL <br /> �c��� �t�J�n�t��s. ���jn p�w �� �l,io,,�a�t'1. l�.zS <br /> CONTft.UCENBE N �' }a; � �Sv'r'��CS , pZ3�� �'8�' <br /> I�.,k�T�i i 4�R �n' � <br /> USE OF BUILDING HEAT SOURCE C�TRACT PRICE OF WORK <br /> � r R �Electric �Gas_Other !�� <br /> WORKDESCR�r`L_1O_N-'Qp,�� �` +�� � �` y.,�, �ai�✓am �'�`r' �w � <br /> b�y,�a i�J� o�?a.(' T�w�.�dor�� � �QP���� .P�.�.�iv.� ,.� bafhrWrv. an� Ac�� <br /> v . ,�.✓ .+. <br /> ,ne.,� :�rwt ( ti� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF PIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> 1 Toilet A/C—air handling unils <br /> � Balhtub Forced alr systems <br /> � Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> = Kilchen sink$�isposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhes dryer <br /> Waler heater � Renge hood <br /> Sink(servlce/bar/mop/elc.) _ [xhaust fan <br /> Back(low prevenler _ Heat pump <br /> Urinal Unit heater <br /> Orinking Fountain _ Boller <br /> Floor dreln ReMgeraUon <br /> Grease Irap _ Woodstove <br /> Rooi dralns Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby ceritify lhal I have read and ezamined lhis applicalion and know the same to be lrue and cortect. All provisbns of lawa and <br /> ordinaces governing lhis lype o(work will be complied wilh whelher apecified hereln or not.The g;�nting of a pertnit does nol presume <br /> lo give aulhority to violale or cancel lhe provision of any othei state or local law regulaUng construc0on or lhe performance of <br /> conslruction.Thal I am,a thorized by Ihe owner of lhis property to periorm the work for which applicallon Is made end I comply wilh lhe <br /> State Contraclors Law 98. 7 RCW and 296.200 WAC. / <br /> , y � � vq <br /> Signa ure of Owner� ontrac or/Authonzed Agenl ate 'I <br /> Z' <br />