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09/22/2068 13:03 4257717956 P,Oh1E!< INC PAGE 01/81 <br /> ,,�... <br /> � <br /> PERMIT APPLI�ATION � <br /> C!TY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETf, VVA 98201 <br /> 425-257-8810 — FAX 425•257•8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEG FROM 8 AM TO 4 PM � '��'�� <br /> S�T[ADOpESS PARCEL TAX I.D.# ER��I��I,.., j� <br /> yPo� C-vErzGr�ccw �a ` �" % <br /> LEGA LOTNO. eLOCK TRqC70RSU6DIVISIONg <br /> DESC. <br /> OIVNER ADDRESS CITY2IP PHUNE <br /> 7CNANT NAME CONTACT FOII PER�d1T PHONE�Q(� - 93�`G�C�I7 <br /> C(.1.+6 ��sC GR�c.r_ F3r2ta�4 Rn6�r1'sa<.r e-MN�ROMRk,iN� deri .�R7 <br /> TflA T R 2oME INC A 1 Y21P �F�— <br /> K� g�?� 1659 Ed�mT�s� VYA 98dLo �a6-JG�-Salo <br /> CONiq.LICENSEN �QM�� x ',75•Kt� / /��/0/ <br /> USE OF�UIIDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ��STAURf�W T ^Electric _Gas_Other <br /> WORK OESCHIPTION <br /> PLUM6ING MECHANICAL <br /> NO. TYPE OF FIXTUAE OR ITGM N0. 7YPE OF KIXTUF[OR ITEM <br /> Toilet A1C-air handling units <br /> _ Bathlub Forced alr systems <br /> _ Lavalory(wash 6esin) �(p_ Gas plping <br /> T, Showor Water hoater <br /> Kllchen sink&disposal Gas fireplace <br /> � �ishwasher r Gas range <br /> Clothes washer Clothes dryer <br /> Waler heater � Range hood <br /> �n Slnk(service/bar/mop/etc.) � Exhaus�lan <br /> � Backllow preventer Hoat pump <br /> Urinal Unil heater <br /> Drinking Fountain � 9oiler <br /> � Floor drain Fiefdgerallon <br /> T Grease trap � Woodstove <br /> Rool dralns _ Other <br /> � Olher r'�Doi2 :SlylL <br /> CITY OF EVERETT LOCAL SALES TAx COOE IS 3105 <br /> I here6y cerl�ify�hat I have read and examined Ihls applica�ion and know the same to be Irue and wrrecL All provlsfons o(laws and <br /> ordinaces governing this�ype of work wlll be complied with whe�her specified hetein or not.The granting of a permit does not presume <br /> to give aulhority lo violate or cancel the provision of any olher state or local law rEgula.ting construclion or the peAormaace ol <br /> Con51rUCUon.Tha[�am authonzed by the owner oi ihls pr�perry lo paAorm the work lor whlch applicalion is made and I compry with ehe <br /> Stale ntractors Law 18.27 RCW and 296.200 WAC. <br /> �c.�-•�� 4/zz/o8 <br /> ignature of O er/Contraclor/Aulnorized Agent Oa e <br />