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PERMIT �4PPLICATION <br /> CITY ��F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org Jb—I S --p 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AMI TO 4 PIM ��J 7� .� �� <br /> SITE A�DRESCU C`r �n 00 C PARCOEL y I.oD O I PER� 1��n �� <br /> J �� <br /> LEGA LOT NO. B OCK TRACT OR SUBdVISION 1 <br /> DESC. ���'� <br /> O NER ADDH CRYILP IE <br /> �,�� C�ico�e�rna�> f2LS SenPm s� # /UU �a-��e C��} 92.� Qq0� 62- d� - <br /> ANT NAME - -- CONTACT FON PERMNT � PfiONE <br /> � �1 �.� ��M � � �Z///�G�s E.�u� <br /> �i �l'J,e�vw��J� ,G�sz �1��'Z�dr�I .S� ,lf/���G <br /> corrrn.uce�•�7/IYl/�ls�,��D�l��� S'�u ,S� �/'✓�'lU�� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Electric _Gas_Other 32 v(/ <br /> WORK DESCRIPTiON <br /> �i15 7���� ,�iu',Lc' �ic�F' �� <br /> �n "x // � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlX7UAE OR REM NO. TYPE OF FlXTUNE OR REM <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 8 disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> ` ClotFies washer Clothes dryer <br /> Water heater Range nood <br /> Sink(service/badmop/etc.) _ Exh�ust fan <br /> Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Dr'nking Fountain _ Boiler <br /> Floor drain Reirigera[ion <br /> _ Greasetrap Woodstove ,r <br /> Roof drains Other �' I <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �hereby ceritity that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type ot work will be complied with whether spec�ed herein or not.The granting of a permit does not presume <br /> to give autlioriry to violate or cancel the provision of any other state or local law regulafing construdion or the perfortnance ot <br /> construction.That I am authorized by the owner of this property to periorm the worlc for which application is made and I comply with the <br /> State Cantractors Law 18.27 RCW and 296200 WAC. <br /> Signature of Owner/ConlractodAuthorized Agent Date ��Z <br />