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FEB-19-2�J�]9 11J:38 P.02iO3 <br /> P�RMIT APPLI�ATI4N <br /> CITY OF EVERETf PERMIT SERVICES <br /> 3200 CEDAR STRE[T, EVERETT,WA 58201 <br /> 425-257-8810—FAX 425-257-8857—www•everetiwa.org <br /> APPI.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Z � �Cj —O� <br /> SITE ADDRESS �S � I ��� PARCEL TAX I.D.g PERMIT Jt <br /> y� � � �� i2�o �.�oo I`n oG i�- v2-3 <br /> IEGA LOT NO. BLOCK 7R CTOR SUBDIV,'I�S/ION M / �� -,�/�- �7 <br /> �ESC. Z �0�� /� 1 r� �G�O� "� Gt�/K[' /J�OG� <br /> o�2j�I�C '> ..uua'yC-e. ��TS AoonESlo�J �l.)�� CT�U� �Je-✓�� <br /> , `y <br /> TENANTNAME _ 1 /� CONTACTFOR�PERrMIT / PHONE 2S' �—IS /n <br /> N Q!�I CQ IlD✓G, f, E•MAIL `^ �� �(X <br /> �BF+TIiXc.`7 ��� �'c��' y��"� 10$2 �'L-3� �r. SE� �oE�^¢}�" �82Da' �{Z�- 3�S ^ `7 �_ <br /> CONTq.LICENSER ��� � �� <br /> A-u-�3t+-y� �z�� <br /> USE OF BUILDING HEAT SOURCE ONTRACT PRI�POF WORK <br /> �p'1�}!)Q I �Electric _Gas_Other I �� <br /> WORK DESCRIPTION <br /> PLUMBiNG MECHANtCAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF PIXTIJRE OR ITEM <br /> Toilet rVC-air haixlling units <br /> J Bathtub Foroedairsystoms <br /> _ Lavaiory�wasli basin) Gas piping <br /> _ Shower Waler heater <br /> Kitchen sink 8 disposa, Gas tireplacs <br /> � Di:hwasher � Gas range <br /> Clothes washer _ Clcthes dryer <br /> � Water heater _ Range hood <br /> _ Sink(service/bar/mopletc.) Eahausl fan <br /> Backllow prevenler ` Heat pump <br /> Urinal Unit heater <br /> _ Drinking FounlBin Boiler <br /> Floordrain � Refrigerat�on <br /> Grease trap _ Woodstove <br /> Roof drains O�her <br /> Other <br /> CITY OF EVEflET�LOCAL SAIES TA%CODE IS 3105 <br /> 1 hereby ceritity that I have read and examined this application and know the sarne ro be true and crorrecL All provisions of laws and <br /> ordinaces goveming this type ol work will be wmplied with whe�her specilied herein or not.7he granling of a permit does not p�esume <br /> to give authoriry to violate or cancel the provision o�any othor state or locat law regulating construction or the performance of <br /> � consiruclion.That I am authorized by ihe owner ot this property ro pertorm the work�or which application is made and I compiy with the <br /> � State Co t L w 78.2 RCw and 296.zoo WAC. <br /> ����'���� �'�,,!I�l!' /is�Y <br /> �ignaNru ot vner/ ontractor Aut�wrR gent Datc <br /> L__-� "� <br />