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_ — —� -- � .. <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERFTT. WA 98201 <br /> ) 425-257-8810-FAX 425-257-8857-www.evereriwa.org 2� t"c- --� 7 <br /> //�C/� ���1` APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRES� L� #-3 PARCEL TAX I.D.N P �T� �, <br /> - lX� � � �- _��3 3 13 �.. , _ _� <br /> LE � LOT NO.-- -- — BLOCK 7RACT <br /> DESC. <br /> AUDRESS CITYILP PHONf�E <br /> OWNER C7YC�"�� C �� V�- ��� � <br /> ,��y�i %Y��r�e�ccu�rw� �� l��� N ;r�,�;� �,� g�av� e a� <br /> TENANT NAME CONTACT FOR P�RMIT I <br /> � I "I CU �x��� � Jc'wit� ,�5-�-�v1 �Iz�� 7�3�b�,�:S( <br /> ,y� y; –�'����ADDRESS CfTYlLP /PHONE ''y��7I <br /> CONTRACTOR �L1C�.L� ��11�LIC1IdY� 'Xl..�. /1II� iG1V� PL .Jw �i�� \������� _d�'C�J I <br /> CON7R.UCENSE i �,n ,., �, i���/_G�I�I 1 ar � q�'�� <br /> �"jL�� ll�J <br /> I�SE OF BUII�ING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �� � l 5; �iOU`'o <br /> G��11�1'1�(�l i _Electric _Gas_Other <br /> WORK DESCRIPTION f I /� <br /> Pl lil���bj�� - (�t�C�v�1,JZti N'l c� ILtlU�1 ► �'l � <br /> �L.� c� <br /> PLUMBING MECHANICA� <br /> NC. TYPE OF FlXTURE OR I7EM i ND. TYPE OF FIX7LRE OR ITEM <br /> Toilet ,_ A/C–air handling units <br /> 8athtub _ Forced air systems <br /> � Lavatory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwastier _ Gas range <br /> Cbthes washer _ Clothes dryer <br /> Laundry tray Range huod <br /> � Sink(service/bar/mopletc.) �� j-�CO�' s�n ks, .1 �s'"k') — Heat pu pn <br /> _ Backflow preventer Unit heater <br /> Urinal — <br /> Drinking Fountain _ Boiier <br /> Floor drain _ Refrigeration <br /> Grease trap _ W�dstove <br /> Roof drains _ Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> I hereby ceritity that I have read and examined this applicafion and knuw the same to be true anA corted. All provisions of laws and <br /> ordinaces goveming this type of work will be wmplied wilh whether spedfed herein or not.The granting of a pertnit does not presume <br /> lo give authorfry tc violate or cancel the provision of any other state or local law regulating constru�ion or the perfortnance of <br /> wnstrudion. lhat I am authorized by the owner of this property fo rFortn the wak for which applicaUon is made and I comply with the <br /> St nUadors w 18 7 RCW and 29�6.200 WAC. � `�,� �,� <br /> '� i � ,fLi <br /> Signa re o vmerlC ntr clorl ut oriced Agent ate <br /> I�_— — <br />