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P�R�YI�� Q����l�s� 1 '�i� ��� I � l�r�5 <br /> CITY OF �V�RETT PERMIT SERVICES ����� � <br /> 3200 CEDAR STREET, EVERETf, WA 98201 P�d� Lf..aq <br /> 425-257-881 Q— FAX 425-257-8857—�wrn�.everetttva.org � CyS <br /> P� ��-�5 <br /> � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM - UE61T & CREDIT CARDS ARE NUT ACCEPTED <br /> SITE t�DQRESS PARCEL TAX I.D.# PERMIT# <br /> 022� �ll P,rc �irl1 pIJlj2o���x.� i �vv �'-'��-�'� <br /> LEGA LOTNO. BLOCK TRACT � <br /> DESC. `�-�0 /�IJiI <br /> OWNEF u�L s�µ,y N ui*�'� o �+'l AODI2ESS CITY/ZIP PHONE <br /> , L.I..C. LH�.f �ihns��,/ 3Nz5 ��Jt"�L .f� �1vtlfu,b}' 7�ZU� <br /> TENANT NAME CONTACT FOR PERh71T PHO,VE <br /> � �n� �G y �i� , _ ��� l' �fd l,�S�,J ��LS� fi7d �163 a <br /> CONTRACTOR OK5f2� C✓� �"'�/"� �DRESS CITY2IP PHONE ���r l <br /> �J �Jut�JL � <br /> CONTR.LICENSE N � 3 JL� �Gt" P� SE_ <br /> COY�s� L�.-rl�NB1 U,�rs ti �jf�y�e 87v-163� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> yi,�y/� ��,.,�/y _Electric ✓as_Other /�� V�70 • c�J <br /> 1 I <br /> WORK DESCRIPTI/O'N 1`M � / ��J�S ��/G� � CJ7 a�'G� <br /> L U�tS�t�f�� AIL..J f c vtq �G /7 �� . <br /> J <br /> L���e e_ � ��- ��(� a s`7 l�� l � �i 5 <br /> PLUMBING MECHANICAL <br /> NO. 1YPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM II <br /> � Toilet _ "!C—airhandiingunils <br /> Bathtub � Forced air systems <br /> �'� Lavatory(wash basin) � Gas piping <br /> �:_ Shower _j__ Waterheater <br /> � Kitchen sink 8 disposal � Gas freplace <br /> � Dishwasher � Gas range <br /> I Clothes washer I Clothes dryer <br /> _f__ Laundry lray I Range hood <br /> _ Sink(service/badmop/etcJ � Exhaust fan j <br /> _ BacMlow proventer _ Heat pump � <br /> Unnal Unit heater <br /> Drinking Fountain Bciler <br /> � Floor drain �(� Refrigeratlon <br /> Grease trap _ Woodstove <br /> _y_ Roof drains _ Olher <br /> Other <br /> CITY OF EVER[TT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby ceritif;�ihat I���ve read and examined this applicalion and know lhe same to 6e true and correcL All provisions of laws and <br /> � ordinaces goveming ihis type of work will be complied vrith whelher specified herein or not.The granting of a permit does not presume <br /> to�ive authonty lo violate ur cancel the provisfon of any other state or local law regulating construction or the performance of <br /> construclion.Thet I am authorized by Ltie owner of this property to per(urm the work for which applicalion is mzde and I comply wilh lhe <br /> State Contreclors aw 18.2?RCW id 296.200 WAC. <br /> �- 0�� � �oy <br /> Signature of 0 /CcntractodA orized Agent Date j <br /> `��, <br /> _ _. _. . �� <br /> — _ ..-„— . <br /> - ��, <br /> e t:�.`. <br /> `��'r <br /> ,��C:� <br /> ���. <br />