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( (� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ,7 <br /> 3200 CEDAR STREET, EVERETT,WA 98201 -�/�6�03 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��QL��07 <br /> SITF ADDRESS PARCEL TAX I.D.• PER <br /> 24 � 1 G'�-eS�ti�r Sf Do�v� 3.,�s-cn�; - o • <br /> LEdA LOT NO. BLOCK TRACT OR SUBDIVISION/ <br /> oesc. � ��i 5 W 5 p -c� l-1� i c r-+ �-4�c /r2� (St �o oN' <br /> OWNER DD E89 <br /> J�� oc SI-�-E� G-C.L� 5 2 y� � c���s�.vP s�f'� c.-v�,r�-Elr G�A' <br /> TENANT NAME I CONTACT FOR PERMIT� PHONE (�Zt ffpZ �CJV I 7 <br /> .�--- /I"1lCSN S(��'(�� EdAAIL T�S/MG tc- M�.1�' <br /> 9 — <br /> CONTR.LICENSE M <br /> USE OF BUILDINU HEAT SOURCE CONTRACT PRICE OF WORK <br /> �� - r (.Z,,��1 (.7-��lC�i _Electric Gas_Olher � ��� �� <br /> WOAK DESCRIPTION /� <br /> LI v (�.�'v 2cv� /'�'D o i Tr esnJ �� /vb'� �' � . <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF Fl%"NRE OR ITEM N0. TVPE OF FlXTURE OR REM <br /> '� Tollet A/C-air handling units <br /> Bathtub Forced air aystems <br /> � Lavalory(wash basin) Gas plping <br /> �_ Shower Water heater <br /> Kitchen slnk&disposal Gas li�eplace <br /> Ulshwesher Gea renge <br /> Clothes washer Clothea dryer <br /> Water heate� Range hood <br /> Sink(aervlcelbarlmop/etc.) Exheust lan <br /> Backflow preventer Heat pump <br /> Urinel Unit heater <br /> Drinklnp Founlain Boller <br /> Floor draln Refrlperation <br /> Grease trap Woodstove <br /> Rool dralns Other <br /> Other <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 7106 <br /> I hereby ceritify Ihat I have read end examined this applicetion end know Ihe same to be true and correcl. All provisiona of laws and <br /> ordinaces governinp tliis lype of work wlll ba complied wilh whether specified herein or nol.The grantinp ol a permit does not presume <br /> lo give authority to violate or cancel the provision of eny other state or local lew regulalinp conatructlon or the performance of <br /> consiructlon.Thal I am authorized by the owner ol ihis pro y to peAorm the work lor which eppllcation Ia made end I comply wlth the <br /> Slate Contradore Law 18.27 RCW and 296200 W <br /> —���_ V"/1 d� <br /> ipn�tme er/ antract oriz gen e � <br />