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Oc ;. i4. iul3 3: 23P'�1 N�. ;i31i ; <br /> --1�.--�_� <br /> PERMIT APPLICATION i <br /> CI7Y OF EVERETT PERMIT SERVICES <br /> 3200 CEpAR STREET, EVER[TT, WA 98201 <br /> 425-257-8810–FAX 425-257-8857–�w,�v,everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO n PM <br /> SiTE ADORE53 � ��S�� <br /> PARCEL TAX I,D.q PEqMIT N <br /> � ►��lu ' w M � �i b-o�v5 <br /> LEGA� LOT NO, ULOCK TRACT Op 3UUUIVISIOM p <br /> OESC.. <br /> OWNER ADDRESS <br /> �ti �es Mvl ho►I � �, CITY2IP pHOWF, <br /> TEN T NAM11[ � t�� �S� r/�YJ •/ <br /> ICONTACTPORPER�d1T PHONE(,'Z� � ��� <br /> T b �G E•h1Al '�e��jE�l%C �hf�l� � . �7�1 <br /> cm�Qa `nq In� ��+�5 gr w�.,.� ��re�t qS�zo� ��5259��6(� <br /> �a��TR��i�11�� �`�"� b9�R4 <br /> USL• OF eUILDING HEAT SOURCE CONTRAC7 PRICE OF WORK ^ <br /> �Eleclric _,Gas_Othcr l I 5�p 2 • �� <br /> WORK DESCRIP710N <br /> �������� � ����4 �s, ���� ,��� �t.��� <br /> PLUMBING MC-CHANICAL — <br /> ���• TYPI'OF FlXTURE OR li@�d N0. iYPE OF FI%TUfiG OR ITE�i <br /> — T����� � NC—a�rhandlin unils <br /> Daltilub 0 <br /> ` Lnvatory(wash basin) — Forced nir systems <br /> _ Showr.r .� Gas pipin{� <br /> Kdchen sink&dlsposal — Waten c�alur <br /> � Distnvashcr _ Gas lireplace <br /> ^ Clopms washer � Gas rangc <br /> Walon c�aler � Clolhr.s drycr <br /> _ Slnk(service/hadmoplefc.) — ���npe hood <br /> Exhaust tan <br /> __ erickflow prevr.nlqr _� Fleat pump <br /> Urinil <br /> Ddnkinp Fountaln _ Unit healer <br /> � Floordr�in � 8oilcr <br /> Greaso�rap _ �alrlperalion <br /> � Rool drains — Wwdsrovr. <br /> ` Olher ��hur <br /> CITY 01'EVEfiETT LOCAI SALE3 iA�(COUC-IS 9105 ^ <br /> I heroby ceAply thal I hnve read and examined Ihls applicatlon nnd iviow tho same io bo Iru�ond conect. All provlslons ol law,and <br /> ortllnacos t�oveming Ihis lypr,ol work witl be complled wiUi whr.Ihr.r specilled herein or np�,The grantinp o(n permil does nol presurne <br /> to pwe authority lo vlolato or cancel Ihu provislon ol any oiher;;�aie or local latv regulatinq tonslrucUon or Ihe per(n�manco of <br /> consuucUOn.Tha�1 qm�ulhorizoJ by the ownor ol this property lo potlo�m U�C vrotk f0�which applicauon Is matic and I wmply with tho <br /> Sla�c Contractors Law 10.27 qCW and 29G.200 WAC. <br /> �12�Ck,C. I�LtiI��� � 0� �� �,�_ <br /> Si nalu ot ovrner/(.o actoi�Aulh �z���pem pa�a <br />