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. _- �_y?���� �' ----- - <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 D - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM 3� a�_ <br /> SITE AD�RESS PARCEL TA%I.D.p PERMIT M <br /> � $��IISDbIDDzod Ml3o3 �OSg <br /> LEGA LOT HO. BLOCN TRACT OR SUBDIVISION/ <br /> DESC <br /> OWNER ADDRESS CITV2IP PHONE <br /> ��s �a�,u Po t�c�707 � ae���� �b��.��d � <br /> 7ENANi NA C TAGT FOR PERMIT PHONE�1/�b•Z <br /> G�/ <br /> � nn� ��n E�hiAI nn •O • <br /> r r �_ C.��DD 1 p � 'L 4�a Sll�of' <br /> CONTR.LICENSE����� /�w/ •^ff71'�JS�� <br /> � /7/(0(�.� T <br /> USE OF BUILDING HEAT SOURCE �/.� CONTRACT PRICE OF WORK <br /> � _Elednc _Gas_✓'Other __ <br /> W�� <br /> WORK DESCRIPTION a ��,V IiA.O �Y� � GN <br /> �� � �n; �ccc�'�t�C �e� �l�""o�' <br /> .o,..�c�' �f+�i,d r.Kish ��htip�Clao�O°2�.t �c�4 2�. — <br /> � PLUMBING MECHANICAL <br /> i NO. TYPE OF FIXTURE OR IlEM NO. TVPE OF FIXTURE OR ITEM <br /> i � lodet = A/C-av handhng unds <br /> Balhtub Forced an syslems <br /> � __ lavatory�wash bas�n� __ Gas p�p�ng <br /> ! Shower ___ Water heater <br /> Kitchen sint 8 d�sposal Gas firepiace <br /> � Dishwasher Gas range <br /> i _ Clothes washer Clot�es dryer <br /> ' Water heater Range hood <br /> 'I _ Sink (servicelbar/m r!,, j -Khaust fan �1' 0.� <br /> � _ 6ackflow preve . _ Heal pump <br /> Unnal Umt neater <br /> ' � Unnkmg F ntain Roiler <br /> I --- I looi , m Hehigerahon <br /> i ___ Gr se Inp Wootlstov <br /> � __ nof drains � Othc��,�,_�AC � sY� <br /> � __ O�her'__._ — '.'_ —_.— � p��un • <br /> �i - — �---� - �-- --- - ---- � <br /> ICITY OF EVEREIT LOCAL SALES TAX CODE IS]f05 <br /> 1 herr.by ceAdy Ihal 1 have read and ezamined this apphcalion and know Ihe same to be Irue antl correcl �II pwvisions of lawti and <br /> ordmanr.es govemmg Vus type ol work wtli be complied wdh whelher specfietl heian or not The grant�ng ol.peimit Uoes not presume <br /> to grve aulhonty to wola�e or cancel the provision of any other state or local law regWaling tanslmct�on or the perloimance ol <br /> con uction T at I am aulhorized by t nr.r of Ihis pioperlY to pe omi the ork tor which aDp�icaUon is made and I compiy wilh the <br /> St. e r a 1 "'.7 RCW an 296 00 WAC <br /> ' zc� i <br /> Signatu onlrac�or/Authonzetl Agen� Date ��7j <br /> � <br />