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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICcS <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-881 U- FAX 425-257-8857-www.everetnva.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM ��_�� —/(� <br /> SITE ADDRESS v PARCEL TAX I.D.M PERMIT k <br /> 3�,�,3 ��. Crs,�� 20 oi - v <br /> LEGA LOT N0. BIOCK TRACT UR SUBDIVISION p <br /> DESC. <br /> OWNER ADDRESS CIT/21P PHONE <br /> (i�L �n� � <br /> TENANT NAME C NTACT fOR PERMIT P�J NE�n6 L�n� <br /> �:d� �,�c �3 Tv` e��� 2 SK I 'e-Ma� i � <br /> 1� /+-Ifr��n. ��l 1NDu< rr��c <br /> CONTR.LICENSE M <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ��OL SµL �� ,Eloclric _Gas_Olher � �(i QCn <br /> WORK DESCRIPTION <br /> CG�A�S1/IiUC,T TO (1L ,5��2�.(� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIl(TURE OR ITEM N0. TYPE OF iIXTURE OR ITEM <br /> Toilol A/C-air handling uni�s <br /> Bathtub Forced air systnms <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Waler healer <br /> Kilchon sink 8 dis�rosal Gas fireplaco <br /> Dishwashor Gasrango <br /> Cb�hes washor Clo�hes dryer <br /> Waler hoator Range hoed <br /> Sink(sorvicolbarlmop/olc.) Exhaust lan <br /> Bach(low preventer Heal pump <br /> Urinal Unit heator <br /> Drinkinc7 Founlain _ Boller <br /> Floor drain Rofrigeration <br /> Groaso trap Woodslovo <br /> Roof drains Olher <br /> Olhor <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hareby coritify thal I havo read and examined this appticalion and know the same to be lrue and correct. All provisions of laws and <br /> ordinaces gov�rning Ihis lypo ol work will be complied wilh whothor spocified hereln or not.The granling ol a permit does nol presume <br /> to give aulhority to violalo or cancol Iha provision of any olhar slale or local law regulating wnslruclion ar lhe peAormance of <br /> conslruclion.That I am authorized by the owner ol Ihis propoAy to perlorm the work lor which epplicalion is made and I comply with ihe <br /> Stalo onlractors La 18 27 RC�and 29fi.200 WAC. <br /> ,�.r,,,� �-/ l��r.�1 � . �a�3 �n <br /> S ynalure of OwnarlConlractorlAuthonzed Agont Dale � <br /> � <br />