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' � — --�' - <br /> PERI"�6T �►PPLI�ATION <br /> CITY OF E`✓�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—EAX 425-257-8857—wwv:.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM <br /> SITE ADDRESS PARCEL TAX I.D.# ?ERM p . <br /> (± � ! rLI <br /> jr%/L/ - g��`G 2y28oy2ooioo ; � �'�" " ��� ! <br /> LEGAI l.OTNO. BLOCK T iRACTORSUBDIVI510Nl/ <br /> DESC. I <br /> OWNER ADDRESS CITY2IP PMONE <br /> � � a ti t� ,e- L[� <br /> IENANTNAME• I CONTACTFORPERMIT PHON S3 y75 -L�`�� <br /> Smok�N /�;��5�� �ea L£r�r�s �LaaG�srs� � E�MAIL LCSTA <br /> -aapraa�r �wCnsrsi<..vs i�c. � ,sy So.G�/� r � <br /> � 5 . ,���,A u�R ��s�y�s-�a 99 <br /> CONTR.LICEN;eaLDuJC05/ 033MP .� . �� _ v �� ygya8 _� <br /> USE OF BUILDING I — HEAT SOURCF I CONTRACT PRICE OF INOHK <br /> �� Eleciric _Gas_Other �p��SD,� <br /> WORK DESCR�PTION <br /> .lsr�c. Sy,�.an acJ,el�a�� ,(��°d�-. �s�va�-F,e..,�) <br /> �srn o%.N N�/1 ss`� <br /> PLUMBIN� MECHANICAL <br /> NO. TYPE OF Fl7(TURE OR ITEM NO. TYPE OF FlX7URF OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas firepl2ce <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking FouNain Boiler <br /> Floor drain Refrigeration <br /> _ Grease trap Woodstove <br /> _ Roof drains _ Other � v <br /> Other / <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this app�ication and know the same to be true and conect. All provisions of laws and <br /> ordinaces governing Ihis ty e of w�rk will be complied with whether specified here�n or not.The granting of a permit dces not presume <br /> to give authority to viol or cancel lhe pr ' any other state or local law reputating construction or the performance of <br /> consiruction That I authorized e owner of is property to perform the work for which applica0on is made and I comply with the <br /> Sta!e Con�ctor w 18.27 R and 2962 AC. <br /> 9/z-�7 <br /> Signalure o ner ractodAuthonzed Agent Date � <br /> (J <br />