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-- � �.. <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAF: STREET, EVERETT,WA 98201 3 _�G� �Q� <br /> 425-257-8810- FAX 425-257-8E57-www.everettwa.org <br /> APPLICATIONS,ARE AC EPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS '� P R EL TAX I.D.N PERMITl/ <br /> �003 w. C�s�Ne � -o� <br /> IEGA LOT N0. BLOCK TRACT OR SUBOIVIStON p <br /> L'c SC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> �j� 1 N(� <br /> TENANT NAME CONTACi FOR PERMIT PHONE� ZS• '_ ,f <br /> �D(�iI P�� L . ASTCM�ORS� E.�taL <br /> ���N �NDusTR �h� <br /> CONTR.LICENSE M <br /> USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ,�a,� St�g� G/'r 2AG� _e�ecmc _Gas_other 97 � 000 <br /> WORKDESCRIPTION 2�F��� �r� STEG�- gv� �-��i�6 <br /> Gor�s r�v�T P <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXfURE OR ITEM N0. iYPE OF FIXTURE OR ITEM <br /> Toilet _ FUC—air handling unils <br /> BaUitub _ Forced air systems <br /> _ Lavatory(wash hasin) _ Gas piping <br /> Shower _ Walerhoater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gasrange <br /> Clothes washer _ Clolhes dryer <br /> Water hoalor _ Range hood <br /> Sink(servica/bar/mop/elc.) _ Exhausl fan <br /> Backllow proventor _ Heal pump <br /> Urinal _ Unil healer <br /> Drinking Founlain _ Boiler <br /> Floor drain _ Retrigeration <br /> Groa:o trap _ H'oodstove <br /> Rool�rains _ Other _ <br /> Olher_ _ — • <br /> CITV OF EVERETT LOCAL SALES TA%CODE IS�105 _ <br /> I hereby coritify that I have read and ozamined lhis applicalion and know Ihe same lo�e true and correcl. All provisions ol laws�nd <br /> ordinaces governing lhis type of work will bo complied with whelher specifiod hereir or noL The granting of a permit does not�resume <br /> to give authorily lo �iolale or cancel the provision of any other slata or local law ragulating conslruction or the peAormance ol <br /> conslruction. Thal I am authorized Gy lhe owncr ol this pruperty to perform lhe work lor which application is made and I comply wilh the <br /> Slalc nlractors Law 18.3�RC and 29�. 00 WAC. <br /> � `~'���� 3���p9 '� <br /> SiynaWre e(OwnedConlraclor�Authorized Agent Dale �/ <br /> L_ <br />