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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ] "I 7—O� <br /> 425-257-8610— FAX 425-257-6657—Hrvu�-.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AN�i TO 4 PM ` (�( '/� �� <br /> SRE ADDRE53 PAHCEL TAX I.D.N PERMIT M <br /> � �'6�b.� l�_I.� � LG yi,��t� :�-I ' �. I c� c ;7,1 � - �%�, <br /> LEGA LO7N0. BLOCK TRACTORSl1BDNIS10NX <br /> DESC. <br /> OW AD SS 21P N ��� _���_� <br /> L� ���cZ, [ur� l �t�_�ic., s 17zz r°��l��r 1����. C,ti��t'-( ii 9S?C� 1 5�,c-3 <br /> TENANT NpME COMACT r-0R PG R PHONE n <br /> (� •_��'`.: ��`J i �"(i' (r(l' <br /> � �[' U��l.� ��JU.UEI.S E-MAIL <br /> , ��, �,. , Irr�rIhlL l���5 /,-;�i � nt�� �_:, ;� 'tc`ctLtrt.. �/5�C / ci ' � � �` t c L G4- <br /> COMA.LICENSE M � <br /> C' il11 �f /� -J� � ��� 1'_�-�_ <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRfCE OF WORK <br /> Eleddc �6as_Other � L� �'-}--�,' i'- <br /> WOHK DESCRIPT�ON <br /> i I i" , �r � L �_ C�Q � �JI'�ll� Gl.. -¢" (.�({" .�� �1C: t L{,,<<�'�' �« i�_ � <br /> J <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl%TURE OR ITEM N0. I TYPE OF FO(TURE OR fTEM ' <br /> Tollet WC—air handling units <br /> _ BaOriub � Forcod alr systems <br /> ,. Lavalory(wash basin) Gas piping <br /> Showcr � Watcr heater <br /> Kitchen sink S hcsposal Gas lireplace <br /> _ Dishwasher Gas range <br /> _. Ciothes washer Clolhes dryer <br /> Wator I�eatar Range houd <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> 8ack0ow preventer Heat pump <br /> Udnal Unit heater <br /> Drinking FounWin Boller <br /> Floor drain ficlrigeratian <br /> Grease trap Woodstove <br /> Roof drains Othar <br /> Other <br /> CITY OF EVERETT LOCAL SALES TA%COOE IS 3105 <br /> I hereby tedtity that I havo read and examined Oiis application and know the same to be irue and conect. All provisions ol Iaws and <br /> ordinaces governing this type of work wlll be complled wflh whether specified herein or not.The pranting ot a permR does no�presumc <br /> to give authority to violato or cance�the provlsion of any olher State or local law regulating conslructian or the performance af <br /> construction.That I am authorized by the owner ol this property ta perlortn the work Mr which app�ication is ma0e and I comply with the <br /> Statu Contractors Law 78.27 RCW�nd 296.200 WAC. —y <br /> �.. '� � . �`) � ' f � 1 �� -� �/ <br /> Signature o er/ nVaclor! honrnd ge�t1 ate <br /> l <br />