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PERMIT APPI_ICATION � �-ag`°�' <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT,WA 98201 . , ;% �I�/�L'' ,1 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org 15 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ' � � � � <br /> SITE ADDRESS 7 PARCEL TA%I.D.M � P�RM��R���+�t 7T �" <br /> 1���� �� �� �16�, �,���� 3�-G,3y(oG'•�/G'O � � <br /> , <br /> LEGA LOT N0. BLOCK TRAC7 OR SUBDIVISION A ���t/1 �� - L)�'� <br /> �ESC. <br /> OWNER ADURESS arrrzir PN�..�E <br /> �� 5�11 ��� �l�L'�l ��l`� ��t'I /ii7't ��� �ElfiG G(,/1L'����[! ����1[�,�, � .il�i. .����[�'02/� <br /> TENANT NAME C ACT FOR PERMIT PHONE _j��� � i � G�J-J <br /> I '�%!l77 I���I I�I�� E�lAAIL <br /> L`bAfAAbY31i_� ( � .�l 7 �j l'U _ <br /> SiC��/'C '1 <br /> r�u,��;��f,,�y � � y.��> �,� ,<� � u, /„>y ��� ���. �, ��_ <br /> CONTIi.LI NSER �} �9_� (�����7�K� — _ �(.��33 <br /> ri / � <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> /�['�SiC�L i lf' L � _Eleclric _Gas_Other � ��, GGU• �' C` <br /> WORK DESCRIPTION ���,�j.��' �� ��xJ 5 ��l�1c� �� G��7 ( j7C( ����L � P I'�/CL �S �d <br /> �/J , �:il� ��Jet�� Y'D07�7nC% b27��� fc-r"� �c���5� <br /> J <br /> PLUMBING MECHANICAL <br /> N6. TYPE OF FlXTURE OR ITEM NO. iVPE OF Fll(TURE OR ITEM <br /> Toilet _ A/C–air hanCling units <br /> BatMub _ Forced air systems <br /> lavatory(wash basin) _ Gas pipiny <br /> Showar _ Water heater <br /> Kitchen sink 8 disposal _ Gas tireptace <br /> Dishwasher _ Gas rango <br /> Clothes washer _ Clothos dryer <br /> Water healer _ Range hood <br /> Sink(servlce/barlmop/elc.) _ [xhaost lan <br /> BacMlow preverner _ Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ Bo�ler <br /> Floordrain _ Hetrigeralion <br /> Grease trap _ Woodslove <br /> = Roof drains =I Other <br /> Other <br /> , CITV OF EVERETT LOCAL 8ALES TAX CODE IS 3705 <br /> I heroby ceriti(y 1ha�I havo read and ezamined this application and know Ihe same to be true and correct. All provisions o!laws and <br /> ordinaces goveming ihis type of work will be wmplied with whether specilied herein or not.7he granting of a peu�:t does not presume <br /> ing've aulhority Io violato or cancel Ibe provision ol any other state or local law mguiating conslruction or the pertormance ol <br /> co stru 'on.That m Ihorized by Ihe owner o1 this property to pedorm the vrork tor which application is made and I comply with the <br /> SI te C t actors �8. 7 RCW and 29G.200 WAC. <br /> � �L�O - � ,� � `-�. <br /> �S�gnature of Ow er ontr clonAuthoriza gent a� <br />