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PERMIT APPLICATION <br /> CITY' OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www,everetiwa.orfl <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM 70 4 PM �� �a3�5 <br /> SITE AODRESS PARCEL TAX I.D.A P MIT X <br /> I�-t D q - L on,baz� f�h��C• l�fi �ll ' �lb <br /> LEGAI. LOTNO. BLOcK TRACT <br /> �cSC. <br /> OWNER T ADD CITY2IP <br /> �a wQ S'Gh a��n p �S a m� a�t -e�'fic.�`�j �FaS- a5� -�3 <br /> TENANTNAME I CONTAOTFORPERMIT PHONE <br /> N� <br /> CONIRACTOR ADDRFSS CITY?JP PMON[ <br /> Nuv4'hcr,u.t.� f".�illCfvr�we� f��.,�,fi,v�, S�,r�,{r•�2' �`Ilcll - (�1 gt'` Si-N� {�Yrt�vYl. <br /> C�NTR.LICEN9Ei � L_ � 7�� <br /> rvvant�95�f D13 7 ��I"1-5 '31 "`-�' 3 '� 3 <br /> U8E OF BUILDINO I HEAT SOURCE CONTRACT PRICE OF WORK <br /> „_ElecMc �Gea,Olher <br /> WORK DESCRIP710N <br /> � �- r►� a v { { r�,p �u �� ,c.,c�'s,� '�`�. � �. �-n.�.r,� <br /> PLUMBINO MECHANICAL <br /> N0. TPE OF FIXTURE OR iTEM NO. TYPE OF FU(TURE OR ITEM <br /> � Tallet A/C-airhandlingunits <br /> � Balhtub _ Forcad aP cyctcros <br /> lavalory(wash basin) _ ��s plping <br /> � Shawer _ Water hflater <br /> Kitchen sink 8 disposal _ Oas fireplece <br /> Dlshwasher � Ges ron9e <br /> Clothes weshar Cloth�s dryar <br /> Laundry tray _ Range hood <br /> _ Sink(sorvioeroedmop/ctc.) ��ustfan <br /> BadcBowpfavsnter ` Hoetpump <br /> _ Unnal � Unk hexMr <br /> Drinking Founqln _ Boilar <br /> � F�oor areln _ ReMperotion <br /> Grease Vep — w0°�0V° <br /> Roo(drains Othor <br /> Other <br /> CITY OF EVEREII LOGAL SALES TAIf GOOE IS 31G6 <br /> I hareby caritify fhat I have read and exam�ned this appllcatlon and know the sBme to be trua and conect. All provisions of levn and <br /> orcilnaces goveming Mis type ot worfc w�lt De comF-lied with whethet spedAed herein or not The granting ot a pertnit dws not prasum0 <br /> to glve euthonty ta violate or cancel the provision af any ather sWte or loul law ngulating eonatruction or lha peAortnanao oi <br /> construction.Thal I am eulhorized by the owncr cf thls properry lo p�rform ine werk for which appllcatfon Is mada and!compry with the <br /> St � ConMedors 7 CW and 296.200 WAC. �� <br /> a3/vS <br /> g eW�e o m�er n ra od ut o zetl gn,p� D�lo <br /> / <br /> r-0��0'd t6dS Z59 09� �0�60 500Z-�Z-hON <br />