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PERMIT APP�,ICATION <br />CITY O� EVERETT PERMIT SERVICES <br />320G CEDAR STREET, EVERETT, WA 98201 <br />A25-257-8810 — FAX 425-257-8857 —��+•ev0reriwa.org <br />qPPLICATIONB ARE ACCEPTED FROM 8 MN TO 4 PtA <br />317EA�DRE�^ ��41,u� �/ <br />i� -+ <br />TAACT OR <br />NAME <br />Z`bATFiAC70R LLG ����02-Z0'�`+SF <br />(jWti A-�rrnF <br />CONTFi• LICEN9E 6 � __ _ <br />USE OF BUII.OINO <br />TAX I.D. it <br />�60o3av 8a� <br />MA�tSa� Si EVEi�Erf <br />W �� <br />HFJ1T ° <br />rr�wn�Ya'Ccrra�2 nEo'1: <br />_ElxlrSc �Ges_Othor <br />WORK DESCHIPTION <br />�n �', ���a�� Q'�� �,X,r�� <br />NO. I TYPE OF I*I%TUPc OH IfEFY <br />Toilat <br />Bnthtub <br />Lavntory (µash becln) <br />Shovmr <br />Kitchon eink 8 disposal <br />DlshWa9her <br />Clathas wnshor <br />W ator heater <br />Sink �aorvlceroarlmopfetc.) <br />8acktlow pr�ventor <br />Urin01 <br />Drinking Fountaln <br />Floor drain <br />Greasetrep <br />Root drains <br />Othnc <br />NO. <br />CONI MAGI Yfuuc � `avnn <br />� b� ` <br />TYPE OF FDCRIRE OR 17EM <br />A/C — alr handlinp unita <br />ForCed alr systems <br />Oas piping <br />Walar heeler <br />Goa flrapleca <br />Oas ranfle <br />Clothes d.ryer <br />Range hood <br />Exhaustfan <br />Heat pump ' <br />Unit henter <br />Boller <br />Refrlgeratlon <br />Woodstovo <br />Other_. �yA� fU��� <br />cITY OF EHEAEl7 LOCAL 9lLLES TA7C cooE IS 71 os <br />I hereby ceritify that I heve raad nnd examined ihis app���bon and knew the soma to be true and correcl, All provlslons of laws end <br />ordinaces govemin{� ihis lype of wo�ic vAll be Complied with wliathar apecltlod hereln or not. The grgnting ot a pert+�il doos not presume <br />to glvo authoAty lo violnte or cancof the provlclon ot nny olhe� slata or local luw rogulatinp conswcllon or the paAormance ol <br />eonstruetlon. Thnt I um aulhotlzed 6y the ownor ol this proporty to perform lhe �� tor whiCh applbnUon �s msdo and I eomply �Jth tho <br />Smto Contractors 1 96200 WAC. <br />r ;j? ��''� i ��- � e - �� <br />Z00/ZOOd XKd j9�6 I8d OZ02/ZT/Ti <br />