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�--- - - <br /> � PF�MIT �4PPLIC�4TI0�� <br /> I CITY OF EVER�TT PERMIT StKVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAi( 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE A:'CEPTED FROM 8 AM TO 4 PIN -DEBIT 8 CREDIT CAkDS ARE NOT ACCEPTcD <br /> SITE AD�RESS '��'CI J "'�Y F PARCEL TA%I.D.R PERMIT!! <br /> , <br /> i�ti.� ,�L ��`c:i�� ji it-r�/( L (�%�^� ��?05fS'�'U }�U �j��UCr� �O�{—DiS <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER �l / LL'��C. `rv h.[.F, Pi`.,�. .l'lc�� , CITY2IP PHONE � ' <br /> )� / � C t�+� l45 J. F�j�)t(,�CL� � ��Z!>> 1Z-_ <br /> F,��;��Gl l�i.t.�'.( I �'i �. � � � i� i.t� � r< <br /> TEN�NTNAME I CONTACTFORPERMIT PHONE <br /> L�it�,f�G-iVT`7�- �Jt�i�t� LC , ���Ll,� ���yL� ��� � �, C DC�. `-�7_l.b lU• 6 jCL� � �U l <br /> CONTRACTOF ADORESS CITYIZ�P PHONE <br /> CONTR.UCENSE iF ` I/"' f S \ � /� L�� ��_j <br /> �J�,�,,. `� �. <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���Z'-'L` � �'t � _Electric _Cas_Other � ����0 <br /> WORK �ESCRIPTION . / � � <br /> 1`tLGc:,.t-�-- _��z.T• hGv..-{� .�c�c �">� r'(.'?�n.CG �i�z�Yt�l��ol.(�::�av"', .�y �IE72��c�Lr� �)�2'Vt�c.. �L:� <br /> � \ , / <br /> 'c.,n,��,,�-; � w�,ll �, a�•c •-i ��(wu, .,.,��� <br /> PLUMBING MECHANICAL <br /> `NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> '� Toiiet A/C—airhandlingunits <br /> ��Balhtu6 � Forcedairsystems <br /> T Lavatory(wash 6as�n) � Gas piping <br /> _ Sh�y,�er \W� ater hea!er <br /> _ Kitchep sink S disposal _ 6as fireplace <br /> _ Dishwas�ier _ Gas range <br /> Clolhes washer Clothes dryer <br /> _ Laundry tray, Rang=�iood <br />- _ Sink(service/b�ar/mopletc.) Exhaust�ap <br /> _ Back�ow prevenl�r _ Heat pump�� <br /> Urinal Unit heater <br /> _ Drinking Fountain Boiler <br /> Flocr drain Refrigeration <br /> _ Grease trap Woodslove �-� <br /> = Roof drains = Oiher \ <br /> Other <br /> ICITY OF EVERETT LOCFL SALES 7NC CO�E 13 7105 _ <br /> I� I hereby ceritify Ihat I have read and examined this applicahon and know lhe same to be true and correct. All proviaions of laws and <br /> ordinaces goveming this type of work will be complied with whelher specifed herein or noL The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulaling construction or the pedormance of <br /> construction.Thal I �m aulhorized by lhe owner of this property to perform the work for which applicalion is made and I comply w�th lhe <br /> State Contractors Law 7827 RCW and 296200 WAC. <br /> , <br /> II . ,U^-'1 ,\ l .. II f�1��LC af�C�J � <br /> Signature of'OwredCoNrac r/A'ul or�zed Agent Date L <br /> �-- --- <br />