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-- ---� — ----- - -- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CE�AR STREET, EVERETf, WA 98201 <br /> 425-257-�id10— FAX 425-257-8857 —www.everettwa.org <br /> APPLI�ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.tf PERMIT N <br /> ��u l.� �l✓I rV�so�✓ /-'�/��E vv i�Sa 5 nnn�,���ac P�I UOZ 01'-1 <br /> LEGAL LOT NU. BLOCK TRACT OR SUBDIVISION/ <br /> DESG � �,��, ,� -c�o -n�c�soN ARK <br /> OWNER ADDRESS CITV2IP PHONE <br /> C � ���� V� I; C� L;'i�.� LMeI`�C�/U/L�L� �VG�.� T �ii,T�'1� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE 4� � .�� 2 G,5�,� <br /> � IJ `J� I:SDi.� h'i-ri 1:��, � ��� � <br /> E�MAIL <br /> /ZIP <br /> /afJJC�ScN �'OGF/,✓G-yNc:._ �����3[�a ,1 c >G 1 55�G�uAN G£r�.� y.2S -.1:�.2 GSC� <br /> CONTR.LICENSE B <br /> nn��� � �z.�o �.�.� <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Eleclric Gas Other �� ���p — <br /> WORK DESCRIPTION <br /> kci;oo� -- ,�„��.� z�;s+.� ��.�p . � ,.a <br /> �Y�Sfq'� �oi�l- �✓�.w0�1 I�k�rj-e �l'���"i� .�.. .,� y�bJ �Q �lr CCh1�. <br /> v <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NQ. 7YPE OF FIXTURE OR ITEM <br /> Toilcl NC-oir handling unils <br /> Bathlub Forced air syslems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal � Gas fireplace <br /> Dishwasher G�srange <br /> Clothes washer Clolhes dryer <br /> Waten c�aler Range hood <br /> Sink (servicePoadmop/elcJ Exhausl fan <br /> BackOow prever.ler Heal pump <br /> Urinal Unit healer <br /> Drinkinc� �aunlain Ooiler <br /> Floor drain Refrigeration <br /> Greasa Irap _ Woodstove <br /> Roof drains Other <br /> Other . <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS J705 <br /> I hereby certi(y Ihat I have read and examined ihis application and know the same to be lrue and correcL All provisions of laws and <br /> ordinances goveming Ihis type of work will be comphed with whether specified herein or noL The granting of a permit does not presume <br /> to give authorih•t i late ncel Ihe provision of any other state or locai law regulaling constmction cr lhe Ue�ormance of <br /> ccnstruclion. I a i au ho ed by Ihe owner ot this propeAy to pedorm lhe work for which appllcalion is made and I comply with Ihe <br /> State Contr ct� L v 18. 7 W and 29�.2 0 WAC. �; <br /> [' E,ac� r ��x� �)�.- �rS���. <br /> SignaWre o wn 'ontracrodAull rized Agent Date <br /> � -- . . . .__._. .— -- ------ <br />