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� .. <br /> . - <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, EVERETT, WA 98201 <br /> 425•257-8810— FAX 425-257-a857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `� �9 <br /> SITE ADDRESS PARCEL TAX I.D.S PE,(i IT It� n <br /> L-ve ago�r� �co oc� 0.3 ' <br /> LEG lOTNO. BLOC TRACTOHSUBDIVISIONU <br /> oesc. 'j� G u E�a,c-+ce; <br /> OWNEH ADORESS CITY2IP PMONE <br /> Frcah+t,�,� ?o . r3cl 3ssw� ru.csa, o�. 'riliS3 <br /> TENANTNAM CONTACTFON PEHMIT PHONE p'((i(p- '7l9-O�S3°J <br /> J P�1't O�u �,(�,ud,c, pvd�A¢. US I 1�ar v1�e e-u�a� � u.mtln�r � atcs, <br /> r�Aw�. e.orst.�,���w, P•o•8�X 33�8 wa«un�c���� 9gu�a- �,,�. <br /> corrra.uceNse a <br /> F4 A�wK[3c.r u3�Fprvt <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> F�� a <br /> Electric _Gas_Other /07 U� O d0 •� <br /> WORK DESCRIPTION ����j -r I <br /> I���ltrio�r'���� al�ICvu�-�m'�s -fU aXAS4�i-t� b0.�t..k ds P�er <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXNRE OH ITEM N0. TYPE OF flXTUHE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub Foreed air systems <br /> lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas tirepl��o <br /> Dishwasher Gas rar�y:; <br /> Cbthes washer Cbthes dryer <br /> __ Water heater Range hood <br /> Sink(servic�Jbadmop/etc.) Exhaust lan <br /> Backl�ow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountafi Boiler <br /> Floo�drafn Relrigoration <br /> Grease trap Woodstove <br /> Raol drains Olher <br /> Other <br /> CI7Y OF EYERER LOCAL SALES TA%CODE IS 3105 <br /> 1 hereby ceritily ihat I have read and examined this appiication and know the samo to be true and correct. All provisians ol laws and <br /> ordinaces goveming this type of work will bo complied with whether specified herein or not.The granting of a pertnit does not presume <br /> to givo aulhority to violate or canccl Ihe provision ot any other state or lacal law regulapng construdion or Ihe performance of <br /> construdion.That I am authorized by tho ownor o�this property to peAortn Ihe work lor which application is made and I compty with Ihe <br /> State CoMractors Law 182 CW and 29G200 WAC. � <br /> � e�- ���° �- <br /> na[ure o ner raclor� uthonz gent ate ,� <br /> L <br /> r <br />