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(c—�30�� <br /> F�f��JIiT APPLICATIvN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS «I YN F�� PARCEL TAX I.D.# ERMIT# <br /> �7� 7 C'�c � �. �o�39i�a soo �oo � �1� c��� -�� <br /> LEGAL L(`T NJ. BLOCK TRn T <br /> DESC. � — t I � _D- o�, �/ERE GA <br /> OWNER ADORESS CITY/ZIP PHONE <br /> Suar�q� /YIti� �� ��c �a8nx s��� �V��� 46'�� <br /> TENANT NAME �(,�'rl� F'�Ulc� CONTACT FOR PERMIT PHONE <br /> i7)E2Yr�c� �c�c-N ��� rt�..an� -/t���z�fs f� �. �- 7�3• � <br /> �o��uN���� �� Scbs�3R�°A��,S. ��T� P���7��3311 <br /> m��:;n(c L�t'��Du� cl8!3�( <br /> USE O� BUILDING I — NEAT SOURCE �/� I CONTRACT PRICE OF WORK <br /> (r�'_ ��L /'� <br /> �nYr'r.2C�� "'� s Electric Gas Other �/�/ O(fQ <br /> � WORKDESCRIPTION QEP, A� �xzST�t�(G G�NZ� GF� G(JA�TG( �V �OZL <br /> � � t�r} <br /> wz�"t+ sP�zT- sYs��,v► �. �. u. � s�z.�rF.rz �.� <br /> � N c T� . <br /> P UMB G MECHANICAL <br /> ND. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet � A/C—alrhandlingunits <br /> Balhtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> I<itchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry trey Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflo�v prevenler Hcat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Re(nc�eration <br /> Grease t2p Woodstove <br /> Roof drains Other <br /> Other <br /> C17Y OF EVERETT LOCAL SALES 7AX COOE IS 31 US <br /> I hereby ceritify that I have read and examined lhis application and know the same to he true and correct. All provisions of laws and <br /> ordinaces goveming this lype of work will be complied wilh whether speci(ied herein or not.The granting of a permit does not presume <br /> to give a�lhonty to violate or cancel the provision of any other slate or local law regulatinc�consWcSon or the performance o( <br /> construction.That I am authorized by lhe owner of this property to perform the work for which application is made and I comply with the <br /> State Contractor a�8.27 RC�nd�200 AC. � � <br /> ' l�G� � � -�o . ��.? -o(.O <br /> Si ure of ner/Contraclor/A thonzed Agent Date ���. <br /> ��I v <br />