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— - --- _ _ _ � - --- ---- � ---- � <br /> PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 <br /> 425257-8810-FAX 425-257-8857-www.everettwa.org <br /> pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `7"�7 <br /> �- PARCEL TAX�D.N PERMIT M <br /> SITEA�l� S� �� ��t Q �il�� l ��� ' � ! '"�)L� �� C � � r �7�ia <br /> LEGAL LOTNO. BLOCN TRACT <br /> DESC pQ <br /> ADDRESS -� CITYIDP PHONE I' CIC1� Z�Y' I <br /> owNe�Gl.�' / � �F%I1<i1. � (oI0 N.l CyR9�`�� n�J� �j(qr/�(o��zot <br /> � uN Z <br /> TENAN7 E <br /> I CONTACT FOR PERMIT PNONE <br /> r <br /> CONTRACTOR G\G.KPI'k C�1St . T-��C.ADORESS�(I�'{ Ia�N1 PL 34�CRYZP PHONE <br /> �-:c.�r�+— �l`630�1 I <br /> CONTR.UCENSE t 5�K E c i 9�5�1 l <br /> USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ZU� f�C7U <br /> /�0�n ���. � �A I E�ectric Gas_Other <br /> l <br /> WORK DESCRIPTION a . <br /> � � � �� yV`�1 �. ��--Q U �—� �J� <br /> PLU IBING MECHANICAL <br /> I 1 NO. TYPE OF FIXTURE OR ITEM <br /> NO. TYPE OF FI%TURE OR ITEM <br /> T ilet A/C—air handling units <br /> � Forced air systems <br /> B tub Gas piping <br /> � � L alory(vrash basin) Water heater <br /> S � Gas fireplace <br /> II _ K chen sink 8 disposal _ Gas range <br /> Di hwasher Clothes dryer <br /> �I _ CI thes washer _ Range hood <br /> ndry tray Exhaust fan <br /> � Si k(serncelbarlmop/elc.) Heat pump <br /> B fiow preventer Unit heater <br /> U al — Boiler <br /> D king Fourtlain Refrigeration <br /> � Fl r drain � — W�dstove <br /> Gr ase trap Other <br /> R f drains . — <br /> — _ <br /> � — <br /> qTY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerftifY that I have read and examined this application and know the same ro be true and correct All provisions of laws and <br /> ordmaces governing ihis rype of work will be complied with whether specified herein or not The granting ot a permit dces not presume <br /> to give authority to violate ncel the provision of anyPotPer�tat�or local law regulating construdion or Me performance oP Y <br /> constructi n T t I 2m h ¢ y th owner of this ro e to rform the work for which application is made and I com I with the <br /> I State C fra rs Law 8. RC 200 WA�_ <br /> � z�7 n T <br /> � � Date <br /> ure o erl ontradodAuthonzed Agent <br />