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i � iUL� = c <br /> �'ERMIT APPLi�AT1�N <br /> CIT� OF E1fERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 I ��S..d 9 <br /> 425-257-8810- FAX 425-257-8857-v�rnv.everettwa.erg <br /> / <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �����i ,�U ��` � 1 <br /> SITE A�U�RESS // \ PARCEL TAX I.D.# �E I # T� <br /> �r._ C;o � �, �G`- �2C � � � '� �/,�-? <br /> LEGAL L T NO. 7 BLOCK TAA�OR SUBDIVISTION# . 1 <br /> oESc. C-� �� —(,�(l� ����.111� ll(�� .L�1�-P.Y�.�� YL�'� <br /> OWNER � ADURESS CfiYlZIP PMON <br /> 3E:o �5�-1 -5��! <br /> � NNUV r��v E � � V'csr n.�►�� I �C� � �yc i � - � �- � I �7 ' C <br /> TENANTNAME CONTACT�FORPERMIT PHON �4,-t.� � - �l-Si� ( <br /> � rcl�ri e.1-IGnSe 1"1� , <br /> � �TC 1'�[i��SC._I'l� E-MPJL 'Cw , C.�71- <br /> �ct�j�� C�•1.�.-,Ztr�� C:�;,s-tr��e ar,, �'-r7�c ' f <br /> CONTR.LICENSE N� .�C�� q G�C � ��=�T I�C�1 �\SV' I� ,�'�!� � ��� <br /> 1.c�3Cj�-CC�L_��N� �U ���"c�j1 <br /> USE OF BUILDING HEAT 50URCE I CONTRACT PRICE OF WORK <br /> �� ( � _Electric __��)Gas_Other <br /> WORK DESCRIPTION � <br /> 1 n� lL�ic�-1-� �`�� I'�-(_�� - v' ,- o� <br /> � � U�� �L>f lS�v l,l�°'��l b •- S �IZ- l l�i� <br /> PLUMBING MECHANICAL � <br /> N0. TYPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> � � Toilet A/C-airhandting unils <br /> � Bathtub �, Forced air systems <br /> � Lavatory(wash basin) � Gas piping <br /> Shower ,� Water heater <br /> � Kitchen sink&disposal 1 Gas fireplace <br /> i Dishwasher Gas range <br /> � Clothes washer I Clolhes dryer <br /> �� Water heater i Aarge hood <br /> Sink(service/bar/mop/etc.) � Exhaust fan <br /> 8ack0ow preventer Heat pump <br /> Urinal Unit heate� <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeralion <br /> Grease irap Woodstove <br /> � Roof drains Other <br /> Other <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify ihat I have read and examined this application and know ihe same to be true and conect. All provisions of laws and <br /> ordinaces governing ihis type of work will be complied with whether specilied 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 regulating conslruction or the performance of <br /> consiruction.That 1 am authorized by the owner of this property to pert:,rm the work for which applicalion is made and I comply vnih ihe <br /> State Cuntractors Law 1827 RCW and 296.200 WAC. <br /> Signature of Owner/Contracror/Authorized Agent Date � // <br /> (Z- <br /> - --- -- — Y�. ,v.� � '- <br /> ��� '�rY.> .�. ,+ <br />