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� <br /> a <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CAROS ARE NOT ACCEPTED <br /> ITE ADDRESS �� �.} PARCEL TA7(I.D.X P MJT/XM�, /� <br /> �"I G(1� U Ul� lJy!/7 4� <br /> LEGA L07N0. BLOCK TRACT <br /> . <br /> DESC. <br /> OWNER AUDRESS CIN21P PHONE Y ( ' <br /> R0� 11 1"It U.�ll � lU �PO�-�1'l�, �� 5�80a3 <br /> �ENANTNAME CONT CTFO ERMIT PHONE <br /> 'I► L �ld.�� �t �uu AtYa.►'� �Z�Er)o'�j�y ul� <br /> cor+ ACTOR �� i�� r���noo ss 01 �tt cinmr PHONE ) <br /> �. ti K��f- �� Fl� � 8�I-�io3 <br /> CONTR.LICENSEItN��7fIR�088D�� /!S `IS��7�� ���^'"� <br /> USE OF BUILDING � I`1 — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> a n Ie <br /> '�� � � Electric Gas_Olhur �I /�(.VJQ� <br /> WORK DESCRIPTION <br /> Per �aelud.�r�iQc� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Waler heater <br /> Kilchen sink 8 disposal _ Gas fireplaco <br /> Dishwasher Gas rango <br /> Clothes washor _ Clolhes dryer <br /> — �, Y Ran e hood <br /> S nk(serv ce/badmoplelcJ _ Exhausl fan <br /> Backflow preventer _ Heat pump <br /> Urinal Unil heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Olhor <br /> Other <br /> CITY OF EVERETT LOCAL SALES 7AX COOE IS 3105 <br /> I hereby ceritify thal I have read and examined this application and know Iha sama to bo true and correct. All provisions of laws and <br /> ordinaces goveming this type of work will be compiied wi�h whether specified herein or not.The granting of a permit does not presume <br /> to givo authoriry to violate or cancel the provision of any other state or local law regulaling construction or the perfortnance of <br /> construction.T m authorize_yIhe owner of lbis property to perform the work tor which application is made and 1 comply with the <br /> State Cont tors La hTYA6.200 WAC. <br /> , , yo <br /> Signa re o Ow �- nt or uthonzed Agont Data <br />