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i <br /> PERMtT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320�CEDAR STREET, EVERE7T,WA 98201 l Z-0 5�0� <br /> 425-2�7-8810—FAX 425-257-8857—www-everettwa.org <br /> D APPLICAT NS ARE ACCEPTED FflOM 8 AM TO 4 PM ��a ' D�-U <br /> SITE ADDRESS �U ,Q,f� PARCEL TAX IA.# P <br /> v E�./E26(L���l i'.� <br /> LEGA LOT NO. BLOCK TRACT 0(i SUBDIVISION M <br /> DESC. <br /> owrrerr STt�.QUES nuoa�� s� �S a� crrrrm vrior� jJg <br /> ''Tl-1E OFj;z�, � '�E LLC�� F'P�mmtina�m Ma di�loi z53 -Svc� <br /> TENANT HAME I CON7ACT FOR .RMR PHONE ,�jD3 ��I I �—C$I�- <br /> (�D�.ln-E�'3'R-�C� Ic..�.n-�s�x-�-� � Nwa� K1 m b�P rK.-C� .��m <br /> �'1 oa�.r�� ,^�cc�,;c�L z�, sE- �•-��a- ��Esr��.�e- S'v3 <br /> �' � corma.�C�x^�o �R.rlmG�z�J K-A µ�LwatiJc.o'�, oe.- Q^ZzZ �0�-1�-lOC� <br /> USE OF BUI'LDING � — HEATSOURCE C6MRA PRICEOF WORK <br /> Eledric _Gas_Other ( �-��D� <br /> WORK DESCHIP7fON =����L` 2 -c��� C�(1Tt1,� IV�� W�LK= ��� <br /> b�x�S � 3 - s�.l.�' L�„�; ti.��� �s�ua� I <br /> L'�.SE.S . <br /> PLUNIBING MECHANICAL <br /> NO. TYP[OF FTXTURE Ofl ITEM N0. TYPE OF FIXTURE OR fTEM <br /> Toilet A/C—air handling units <br /> BathtuB � Forcedairsystems <br /> Lavatory(wash basin) _ Gas plpi� <br /> Shower Water hoaler <br /> Kitchen sink E�disposal _ Gas fireplace <br /> Dishwasher ____, Gas ran8e <br /> Clothes washer Clot�os dryer <br /> Wate�r healer Range b:xJ <br /> � Sink(,orviculbar/mop/etc.) _ Ex�aust Fan <br /> Bac6�iow preventer Hoat pump <br /> Urinal ,� Unft heala� <br /> _ Drin!cing�ountain 6oiler <br /> Floordrain g RehiperaCbn <br /> � Grease hap Wa�1w� <br /> Roof drt�fns ^ OVier <br /> Other <br /> CITY OF EVEHETT LOCAL SAIES TA%COOE f5 910.a <br /> 1 hereby ceriliry thal I have read and examirmd thi�npplication artt!know tbe sama to be lrue artd cortect. All provisions of la..s and <br /> ordinaan povoming this typo of work will be compfied with whother spe�cified herain or rn:�.lho granting of a pemtit doas rto[presume <br /> to flive a!dhoriry to violate or eancel lho pro�ision of any olher state or local law rogulaUng constructfon or the padortnance of <br /> conshuction.Tha[I am authonzed by the o+mor of this propedy fo pedorm tha work for whlch anpiication is made arxi 1 compty with[he <br /> Stats Comr rors Lnw 1�.27 RCW and 29�.200 WAC. <br /> ��„� _� �ZI�I�De <br /> Signaturo of Ovmod rtraGod ut onzo gent Dalo <br />