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--------i — <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98�01 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROPA 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT po�_D 1� <br /> a,� C e ve�9n d� I ��'S�0 _ <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION M <br /> DESC. <br /> OWNER AODRESS CITYIZIP PHONE <br /> �qr�/ 6'✓�are�v aoa� C/e�f/q��1 �r���1t 98ao� ��s- asy-���� <br /> TENANT NAME CONTACT FOR PERMIT PHONE Nj,f_y��� f� 71 O <br /> / / <br /> -��� � /'rr�l .�ec,Fir9'✓� E-MAIL i. P rw/e� �a�i►+ •.�/ct <br /> �,,����9�,,�—�� � �x s3Y ��u,�,f►� it�.�« Y�S�r6 �y7�o <br /> CONTR.IICENSEN �rqo�ir�' U66BG 9'Y°Y3 <br /> I USE OF BUILDING HEAT SOURCE CONTRACT PR�CE OF WORK <br /> �PS/�rpy�Y� l�Wfe I _Electric _Gas_Other � l�d�i. bv <br /> WORK DESCRIPTION <br /> /Z��c e�'l�q /'�,r,Fin� �7rTft��tl Wn� ��r1�4/� Mw 9cr �•,� fa <br /> �9n��1'qcfcR3 Sp�c/{c9fi�,�,f• <br /> — PLUMBiNG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilel A/C–air handling units <br /> Bathlub forced eir syslems <br /> Levatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen s�nk&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes wnshr.r Clothes dryer <br /> Waterheater Renge hood <br /> Sink(scrvice/bar/mop/etc.) _ Exheust lan <br /> Backllow preventcr _ Heal pump <br /> Urinal Unil heater <br /> Drinking Founlain _ Boiler <br /> Floor dre�in Refrigeralion <br /> Grease trap _ Woodstove <br /> Roo(dreins Olher <br /> Other _ — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�106 <br /> I hereby certily Ihat I have re�d and ezamined this application and know the same lo be Irue and correct. All provisions of laws and <br /> ordinances governing this type ol work will be complied with whethor specifed herein ar not. The grenling ot e pertnit does not presume <br /> to give authority to violale or cancel the provision of any other s'ate or local law regulating wnst�uction or the periormance of <br /> construction. That I am aulhorized by the owner ol this property to peAorm the work lor which epplication Ia made and I comply wilh ths <br /> Slate Conh .tors La 1827 RCW and 296200 WAC. <br /> i G � U <br /> 6 <br /> Sig Wre o Own o itr c r/Authoiized Agent D e <br />