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,_ •. <br /> f ', <br /> � PERIlAIT AP�LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810- FAX 425,?57-BR!i?-www.everettwa.org <br /> {L� �I L��%1 �`U -`��f ( APPUCATIONS ARE ACCEi-i ED FROM�S AM TO 4 PM ���'�'�7 <br /> SITE ADORESS ,� PARCEL TAX I.P.N �IT N <br /> �1 � C� �) U � ���'C ';� � .,s' ' ' 1� ����, ��l'� ' � <br /> LEGA LOT NO. BLOCK TAACT OR SUBDIVISION 11 <br /> DESC. <br /> OWNER ADDRESS CITV2IP PNONE <br /> 1-lL.�,�- l_ IC�.`�;)Y_ � ` � �� ::�`>� c� i�. i.� '„�. . �.iC_ F\ 1�.� ) -'TI•_�� (.�.7Y� . <br /> TENANI�NAME CONTACTFORPEHMK PNONE ��i� .�- ,y' S�l� � yCj <br /> �L'v r�B-- L_ r_ �. . . _ � <br /> e�a� <br /> Z`Ti t(L.0��Qi <br /> CONTR.LICENSE M �k^��`( <br /> USE OF BUILDING I — HEAT SOURC@ I CONTRACT PRICE OF WOHi: <br /> �� �� �� � � � � � Electric Gas_Other .�, � .� ��� <br /> WORK DESCRIPTION • � <br /> ��. �1V -� �r. i �„1A�.� i:�- lt �)'_`, tili� .i7C:_ - Ii����.LCt�.� c�` L�l �'�'-.T� �.)'�C'� C '111� ��-� <br /> ( i \. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE Ofl ITEM NO. TYPE OF FlXTURE OR ITEM <br /> Toilel •� A�C-air handling unils <br /> Ba1hWb Forced air syslems <br /> Lavatory(wash basir) _ Gas piping <br /> Shower _ Waler healer <br /> _ Kitchen sink 8 disposal __ Gas lireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clolhes dryer <br /> Waler healer Range hood <br /> Sink(service/batlmop/etc.J,2 _ Exhaust fan <br /> .�-� Backllow preventer Heal pump <br /> .!/.1 Urinal _ Unit healer <br /> Drinking Fountai� _ Boiler <br /> Floor drain Relrigeration <br /> G�easetrap _ Woodslove <br /> Rool drains Other_ _ <br /> Olher <br /> CITY UF EVERETT LOCAL SAlES TA%CODE IS 3705 <br /> I hereby cerilily Ihat I have read and ezamined this application and know ihe same to be true and correct. All provisions of laws and <br /> ordinaces g�veming ihis�ype ol work will be complied wilh whelher specilied herein or not.The granling ol a permit does nol presuae <br /> lo give authority lo violate or rance�the prmision ol any other state or tocal law regulaling conslruction or U�e performance ol <br /> construction.That I�m aulhorized by the owner ot this property to pedorm Ihe work for which application is made and 1 comply with the <br /> Stale Coniractols Law 1827�W and�96.200 WAC. <br /> , / � ' ������- <br /> /.: �.-/!� ;i G�G� � .'J . - �' . � <br /> Sig�r at e ol Owner/Conl d �u:.� rized Agenl ate <br /> c <br />