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� . <br /> PERMIT APPLIC,a4TION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR Sl'REET, EVERETT, 'NA 98201 � <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATiONS ARE ACCEP'fED FROM 8 AM TU 4 PM <br /> SITE ADDRE55 PARCEL TA% I.D.N PERMIT N <br /> ' S25 �OLB /rU-L QiJqSj�{OU7Ui3in� 2 , <br /> � <br /> LEGA LOTNO. BLOCK TRpCTORSU801VI:lONM <br /> DESC <br /> OWNER ADDRE55 CITY2IP PHONE <br /> CoF�r��T .��J�rna�=�.�T W�2,,��P �cc PoBox �fs3E� c�1�r,3A- �zo� ¢zs-z.sz-5i� <br /> TENANiNAME CONTACTFORPERMIT —pHONE 25_�7f/, p�D�y,/ <br /> /(7- ll 7 <br /> IO�jtj IlJ��I.C.. e�a�-tb.��{,�v/ <br /> AD6RE �r�'/�n�cMc'�A�fq �U� <br /> .t��� <br /> �V�11F�L IVt&Gdd+J�(;�L �AIC . 217!'$ GG� /�d� uJ �Zo-7 MulA1fU4IC��7Tuek�[lc.,�I�y,o•�3 <br /> CONTR.LICENSE N <br /> oLymPmS�.1�2 Q2S-77¢�B�f/ <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> _Electric �Gas_Other �S(�=- <br /> WORKDESCRIPTION ;�G,,,,,JE �����,'/ � y (�t� �N .T�� �G �` /NST�LL <br /> A NG.W G�4S Mu••, r.�� <br /> Fu��.� r� �TS P�. C'ONNk�T � -,-r-� ���nN� nuc��c, <br /> Gh� ��P�N4 � V�n�rNU. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet NC-air handling units <br /> _ Bathtub T Forcedairsystems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> _ Kitchen sink&disposal Gas fireplace <br /> _ Dishwasher Gas range <br /> _ Clothes washer Clothes dryer <br /> _ Water heater Range hood <br /> _ Sink(service/badmopletcJ Exhaust fan <br /> _ BackBow preventer Heat pump <br /> Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Refngeration <br /> Grease trap Woodstove <br /> _ Roof drains plher <br /> Other — <br /> CITY OP EVERETT LOCAL SALES 7A%COOE IS 5705 <br /> I hereby certi(y that I have read and examined this application and know the same to be true and correcL All provisions of laws and <br /> ordinances goveming this rype of work will be complied wdh whether specified herein or not. The granting of a permit does not presume <br /> to give authonty to violate or cancel the provlsion of any other state or Iocal law regulating construction or the performance of <br /> construc6on. That I am auth nzed by the owner of this property to perform the work for which application is made and I comply with the <br /> State Co tract aw 18. RCW and 296200 WAC. <br /> -2 —2vlv <br /> Sign r o wn r/ trac Authonzed Agent Date <br />