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4 <br /> � PERMI�' APPLIC.4TIOIV <br /> � CITY OF EVERETT PERtJIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-5810 — FAX 425-257-8857—www.everettwa.org <br /> APFLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �53 L-U:;r2� 2�1 wn� Sa 3�bio3loo �t U� _C'�'ir <br /> LEGAI LOTNO. BLOCK TRACTORSUBDIVISIONp <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> I eli�c. JN�FIu-v+�aFt C�n1�rY P.�,`3dx l30�0 ���Rc 11t�� �zs��9-3� <br /> TENAPITNAME CONTACTFORPERMIT HONE ZpE, 41�, ($2�. <br /> ��{{e. JrNt1'}��N11 �J(J� I ��1 lJt�..� �.$ E•Ma��po.Jt�3�L�Y`.bn;.{�- rt� <br /> Z`bAT�T+ � <br /> �R- /��}� ��►a A�F��RT ���t s s�n�/�rsr�t 2�6.4b�.�5cc <br /> I CONTR.LICENSE p <br /> 7�A'DL3�1 (''6Zz J�' <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Elec�ric _Gas_Other <br /> WORK DESCRIPTION (' <br /> I� �rZ1W611'll��. oT O�X�S'�'1 ln� �J� 3��o c5� s'��-�'��"1L. <br /> (J <br /> ! PLUMBING MECHANICAL <br /> �, N0. TYPE OF flX7UflE OR ITEM N0. NPE OF FI%TURE OR ITEM <br /> Toilet _ WC—airhandlingunits <br /> Bathtub _ Forced air systems � <br /> _ Lavatory(wash basin) _ Gas piping <br /> i Shower _ 'Nater heater <br /> Kitchen sink 8 disposal _ Gas firepiace <br /> Dishwasher _ Gas range <br /> i _ Clothes washer _ Cimhes dryer <br /> Waler heater _ Range hood <br /> Sink(serviceibarlmop/etc.) _ Er.haust lan <br /> Backllowpreventer _ Heatpump <br /> � Urinal _ Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floordrain _ Refrigeration <br /> Grease trap Woodstove <br /> � Roof drains _ O�her <br /> � Olher — <br /> CITY OF EVEHETT LOCAL SALES TAX CODE IS 3105 <br /> , '!� I hereby ceritify that I have read and examined Ihis application and know the same to be tme and correct. All provisions of lav�s and <br /> � ordinaces goveming this type ol work will be complied with whelher specified herein or not.The granting ot a permit does not presume <br /> to give aulhority to viotate ar cancel the provision of any other state or local law repulating construction or the pedormance of <br /> � constmction.That I am autbarized by the owner of Ihis prope�ty to pedorm the work for which application is made and I comply with the <br /> ' State C nlractor La 18. CW and 296.200 WAC. <br /> � Signawre o�Owner omracror/Authorized Agent e�e O� <br />