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( ' <br /> ; <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3290 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> StTE ADDRESS PARCEL TAX I.D.11 �MR R <br /> \�'i� C.w.�s`t Tw�w.,.. Fu=��tC A� �5 3D�AD/ U c—_ - „� <br /> l[GA LOT NO. BLOCK 7AACT OR SIIBDIV1510N I <br /> o�so. �y �2 ` z�?� � d�- NIL1DNs /kap o � <br /> OW1Eq ADORFSS CfTY21P PF10ME <br /> l�o, �..c.�+w'� Iv+sc. 425-9�,3—`�9'z� <br /> "���k4. Ka�y �s;���,.�u_ �,z:�. <br /> TENNITNWE CONTACTFOflPE1Mff Rq11E ��7.T �J6C. 5�57 <br /> �ckal�qTtcyS"Tt�.w�-c.�, Is�1=t�.1Ti. �7�'�Sai E�ANI�I�b'�e.s..,Ny..�.t.co <br /> �-��'<'c� �`fJlf� 1^+R�l LLc U1w.+�k'•�l� l+'L�i3�i'MN.IL �j-� -�-� <br /> �Y.�-5 ��-� ,o�( <br /> CO!rtA.UCENSE 1 <br /> i'�'c_*t_t_��iS7CZ :�1 �� `�r:.";3 <br /> USE OF BUILDINC I — t��T SOURCE I CONTRACT PRiCE OF WOAK <br /> (��..., Stnr.c..t f��w�( ►'=h�7�. Electric x Gas Other ��Ct7�,,7C1� ��'9.3�)� <br /> �- i <br /> wOHK oESCR�PiION��,,,,o UF :;.1c�S i�vt.. Qw S�C!' ho+�– '' �''va.<�. . l'.A+L�,:wt v• •� • <br /> ZZT•x) 5� �t • z���U�.. 4..w-I.� v�,t,�Ec..,,.4r <br /> 0 <br /> ( Q,�LY-��JQ L�Su,c'�l ,r�7�0,5' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF fl%iUflE OR REM NO. TYPE OF Fl%TVRt:.7R ITL#1 <br /> Toilel A1C–air handlirg units <br /> ���� Bathtub J_ Forced air systems <br /> Lavatory(wash basin) �. Gas piping <br /> �_ Showor � Water heater <br /> �_ Kitchon sink 8 disposal _'_'Gas Iiropiacr � <br /> l �ishwasher _j_ Gasrange <br /> �__ Clothes washer � Clothes dryer <br /> '� Water healm S __ Range Mod <br /> Sink(servicebar/mop/etc.)��,�o��,�,'� �- Exhacst fan <br /> ___ Backllow preventer � _ Heal pump <br /> Urinai _ Unif heater <br /> Dnnking f-ountain � l3oiler <br /> _Z FloordrainRk- � Retrigeration <br /> Greaso lrap __ Woodstove <br /> � Roof drains _ �e� <br /> Olher _ <br /> C(TY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby cerili�y ihal l have read and examined this applicatlon and krrow tbe same ro be We and cortect. All provisions ol laws anu <br /> ordinaces governing this type ol woAc will be complied wilh whether spec'rfied herein or rroL The qranting ol a permit c�oes not presume <br /> to give authority to vlol�le or cancel the provision ol any olher state or local law repulating consWction or tbe performance ot <br /> conslructio .That I am aulhorized by the owner ot ihis property to peAorm the work for which application is made and I comply with the <br /> State Co ac rs Law 1827 RCW -96.200 WAC. <br /> � 5�3/r�3 /� <br /> Sig aWre ol OwnedContracto/Au onzed Agent �a e �� <br /> I <br />