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�� ( i <br /> '� PERMIT APPLICATION <br /> ���`'� � �``���' CITY OF EVERETT PERMIT SERVICES <br /> �)� �� � 3�00 CEDAR STREET, EVERETT, WA 98201 <br /> ��� �S. �U 425-257-6810-FAX 425-257-8857-www.evereriwa.org <br /> '�` ��,`�' APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SRE ADDRESS PARCEL TAX I.D.k ERMIT tt <br /> 1G� 0 ��: c:1 Sc:u\1� Oo4yq0o3�o 30 l ��� -�� <br /> LEOAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ".,cj�cJ 1-'� REB CI IZIP O <br /> KUrE�, W�alS1� f'�� R�I S ��nux�od. �.�fr�' 7r�3� kzs--� � q w <br /> 1�Ic�nc�A �,�i. �c�r�:� 5`IZ ) lto�+h PI 51� L./nnu�c»dqso3`� yz5 -7H5- y3%Z <br /> TENANT E CONTACT FOR PERMR PMONE <br /> 1�//\ t�c���c.�� �r��tia���� N25-'14 5- 4 3�l Z <br /> CONTRACTOR AODHE88 CRV21P PHONE <br /> CONTR.LICENSEt p��n�,r5 -�o ����� I� -� !O" I � <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Elechic Gas Other <br /> WORK DESCRIPTION <br /> �Q.ttilO\i � �C�� �K�`�� � ri(� HC�aSt. Qrit� C>��� ��ln� ���nG�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE QR REM <br /> Talet AIC-eir handlinp units <br /> Bathtub Forced alr syetems <br /> Lavatory(wash basin) Gas pipinp <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplece <br /> Diahwasher Gasranpe <br /> Clolhes washer Clothes dryer <br /> Laundry tray Ranpe hood <br /> Sink(service/barlmop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit haeter <br /> Drinking Fountain Boller <br /> Floor drain Re6lgeration <br /> Grease Irap Woodetove , <br /> Roof drains Olher <br /> Other <br /> CITY OF EVERETT LOCAL SALE3 TA%CODE IB J10S <br /> I hereby cerilify that I have read and examined lhia applicatian and know lhe same lo be true and correct. All provisiona of laws and <br /> ordinaces governing this rype ot work will be compiied with whether specKed hereln or not.The granting ot a permit does not presume <br /> ro give aulhoriry to violale or cancel the provision ot any other stete or local law repulatlng conaUuction or�he peRormance af <br /> construclion. hat I am auihorize by the owner ot this property to peRottn lhe work for which applicatlon is made and I comply with the <br /> State Co clors Law 18.2 R 2 6200 WAC. <br /> %,�f 2 (/ � <br /> Sign re er wnVador! u nz gent ate <br />