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1 <br /> —�— —_ <br /> PtRMIT APPLICATIbN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ( _��—O� <br /> SITE ADDRESS 45 -LJ 'L pARCEL TAX I.D.1t PERIAIT p <br /> s��0 7 ��� s i CA��No �c � l � r1'� ;�-�,/D <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION fl <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> t`5 J("�N<� � <br /> TENANT NAME CONTACT FOR PERMIT PHONE 9z�-- 6'�!0 -ISLI'I- <br /> h,;� /�UC7 LCN /i�T2�MBJ�SkI �ro�a�l.Asfa.rn�,>Ic,� <br /> E-MAIL �ioe�nG , lcnl <br /> �ITPIZI��AaF1E�— <br /> ��qC�tdO l'2d5TK'uc71aN !n»��«•/,�N( �� " sout�l Artt� 9 i ZON-�Ic2. 111Z� <br /> ��1 Zi �O7 A✓� `r � g vt <br /> CONTR.LICENSE p <br /> c�R�y�nCC ii; OMW <br /> USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK ' <br /> C�'��� �>>a<<TZ•�2 _Elec�ric _Gas_Olher �'t�J� OJ J <br /> WORK DESCRIPTION <br /> (��,ti i1'q< lOf. 1-D P�'��•����i� NILV e�2L-�V SHFe7-[K 7p M.1Tri{ e XISi7Nf� StIE�Ti'M S�ZC`� <br /> ��v� oll'1�C71�N N,9iLtiCll1CS Alvp IN12�IJr� CJNF/6N�C.4 �0/✓ , <br /> PLUMBING MECHANICAL � <br /> NU. TYPE OF FIRTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM �� <br /> _ Toilet A/C-air handling units II <br /> _ Bathtub Forced eir systoms �� <br /> _ Lavatory(wash basin) _ Gas piping I <br /> Shower Water hoater � <br /> Kilchen sink 8 dispos�l Gas lireplace <br /> Dishwasher Gas range <br /> Clolhes washer Clolhos dryer <br /> Walor heater Range hood <br /> Sink(servicc/barlmoplcic.) Ezhaust fan <br /> Bachflow pr�vonler Heat pump <br /> Urinal UNl heater <br /> Drinking Fountain Boiler <br /> Floor drain RefrigeraUon <br /> Groase Irap Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby corilify ihal I have read and ozamined lhis application and know the same lo be Irue and correct. All provislons of laws and <br /> ordinaces governine� this type of work will bo complied wilh whelher specified herein or not.The grantiny of a permit does not presume <br /> to give aulhority to violate or cancel IhA provision ol any olher stato or local law regulaling conslruction �r Ihe periormance ol <br /> conslruclion That I am authorized by lho owner of lhis propeAy to pertorm the work for which applicali�,n is made and 1 comply with lha <br /> Slate CoNraclors Law 1D.27 RCW and 29G.200 VJAC. <br /> < <�� � %�n_,�l,�n�o-� Z3MFN�g. <br /> Si9n re of OwnedConlractor/Authorizoa Agenl Dale <br /> � <br /> � L <br />