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SI'(E ADDRESS <br />7 � L6uJZ / <br />LEGA n�o; NO. <br />DESC. r ^, <br />OWNER . <br />�Yl-�. R,a�c <br />TENANTNAME <br />�a,�� <br />F'ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVlCES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — Fi+X 425257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (�_ r� —�� <br />PARCEL TAX I.D. # PERMIT # <br />r v,�,c�. oc�3y�.00000aao3 Riao�- of� <br />� pCK TRACT OR SUBDIVISION # .�^,,�/ �� .�! <br />—h'� � .Ra i 10 v-i � i, � i�" /�. {r! /1 _GO. I 1 W(iW <br />'J�03 LGw-e� <br />�V CONTACTFORPEkMIT <br />� A���, S� <br />f�q6R w.��rncaa <br />�a�S�e�L ��cl�v • �7��-Cd(� �i S�IE:.�o <br />USE OF BUILDING <br />IWORK DESCHIPTION V <br />►(.� r�s�c�c� l8 �X <br />�G�Y�-�i4� ' NO 0 <br />� HEATSOURCE <br />_Electric _Gas_Other <br />�D3 5�'as• �53 � 88 <br />PHONE iJ�O. g as • ` / <br />i1rmP rM�nt <br />�un-� e.Ea,�.c) � goa, <br />3�0• 8as� �7�8 _ <br />ICONTRACT PRICE OF WORK <br />O'1 �j / DV <br />:� i� � dl ��u,c�?ec�- �n � a-�e .� �?'�� <br />,_ � . ,., _ _ .. e ,. __... <br />� V PLUMBING , / <br />NO. I TYPE OF FIXTURE OR ITEM N <br />Toilet <br />Bathlub <br />Lavatory (vrdsh basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes v2sher <br />Wa[er heate� <br />Sink (servicelbar/mop/etc.) <br />— gackflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Vap <br />Roof drains <br />Other <br />MECHANICAL � <br />� NO. I TYPE OF FIXTURE OR ITEM /� <br />A/C — air handling uni5 <br />Forced air systems <br />Gas piping <br />Waterheater � <br />_ Gasfireplace ►,�� {� <br />_ Gasranga �" C� <br />Clothes dryer <br />Rangohood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />G7Y OF EVERETf LOCAL SALES 7AX CODE IS 3105 <br />I hereby cerlify that 1 have read and examined this appiication and know the same to be We and wrrad. All pmvisions of Iaws 2nd <br />ordinances �oveming this type of work will be compiied with whether specfied herein or not The granting of a pennit dces not presume <br />tn give authotity to violate or wncel the provision of any other state or local law regulating mnstructio� or ihe perfortnance of <br />consVuction. That I am authorized by the owner of this proparty tu perfortn the work for which application is made and 1 comply with tho <br />Shate ConVadors Law 18 27 RCW and 296200 WAC. <br />/`� <br />� �!'�il;l, i .'�/.f,li �n.r � � � L' <br />nuthonzed Agen: �^� � <br />l Z <br />� <br />