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�' <br /> i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425•257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `O �' � <br /> SITE ADDRESS PARCEL TAX I.D.li PERM�T� � _ <br /> 8530 Et/er rcerJ �fe� $U�l/300/Do80d �'�- <br /> LEG T N0. BL TRACT OR SUBDIVISION R <br /> oesc. � L' Uf E�' <br /> OWNEH ADDfl SS CRY21P PHONE <br /> �'ju�1 %J1,ec�e✓ /,D• f✓� 355�f7 TuLSQ,UK 75�/S3 <br /> iENANTNAIAE COHTACTFORPERMIT PHONEaQ�j—'��G1�'J�J9 <br /> P �10r �CQ� �u�iNfl'I �iCI�OIl�'!'tJ e.Ma� G arulinG e,� <br /> " �anz��dx��'fx,ta�lu-x- - � <br /> S�KuS 3��ao �t,��,y,�,� s y4u/unl�u.i�- a53- 791-3g <br /> CONiR.LICENSE• �JgGD � <br /> D�a� oe s 9s� �� <br /> USE OF BUILDING I HEAT SOURCE I COHTRACT PRICE OF WORK <br /> ��_, /i _ �Electric Gas_Olher ��Q/ QQp .� <br /> A/YVY/ <br /> WORKDESCRIPTION j_�lO���/���� Q/��?���r���.r ��[aJ c�L� <br /> P�icSG�� �Ya�X�Yc$Cc.f�/"(c� `�9 lLl�Pl'Z" /l�1�nOr5 <br /> PLUMBING ' MECHANICAL <br /> NO. TYPE OF FlXTURE Oli ITEM NO. TYPE OF flXTURE OR ITEM <br /> _ Toilet A/C—airharxflingunits <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas lireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clolhes dryer <br /> Water heater Range hood <br /> Sink(service/barlmop/etc.) Exhaust(an <br /> Backllow prevemor Heal pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Relrigeralion <br /> Grease trap Woodstove <br /> _ Rool drains � Other _ <br /> O�her _ <br /> CITY OF EVEREIT LOCAL SALES TIUt CODE IS 3105 <br /> 1 hereby ceritify that I have read and examined this application and know the same to be true and cortect. All provisions ot laws and <br /> ardinaces goveming this type o�work will be complied with whelher specified herein or nat.The granting of a permil does not presume <br /> to give authority to violate or cancel Ihe provision of any other slate or local Ww regula6ng construction or the perfortnance of <br /> construction.That 1 am aulhorized by the owner ot this property to poAortn lhe work for which application is made and I comply with tho <br /> Siat/e/f,,ontractors Law 8.27//ff��//W and 29G200 WAC. <br /> .�(A/�i(.f � -!'��j�L � '� �/ <br /> nature o er amradoT/Aulhon�Agent — ate <br />