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��R <br /> '� k f . �y���M< <br /> +.. �1^ r '� ��UM„��h I� '�.�t�✓+�'F!"kt� I '� ; '� <br /> �tt'�r. . �'�°"�' '`.. _ w. .t'° .,��� `,�`,s.n__� _.,.. G.... .,�:...r..5 "5 „M.s.'i�..._. . �t I�'I�I� <br /> „r <br /> � <br /> PERMIT APPLICATION I <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9Fi201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org S_..1 �j—�5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREC;iT CARDS ARE NOT ACCEPTED _ <br /> SITE ADDRESS PARCEL TA%I.D.# I P IT fl � � ,� <br /> <" � <br /> ��VJu I���-' � ^L�d� :� �- 130D� �LIOD � CS .7 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> ' a2 i�L��U� �-�c. �6� �� >�w; /Jn_ C�ae i s�g ��� �i��_3s�:-��< � <br /> TENANT NAME Cp NTACT FOR PERMIT PHONE <br /> � {�-,�j.�- •�%'i G/I L I nlf-�s lL.�y-:�.� 7�v- � �s-S���- <br /> � CONTRACTOR ADDRESS C�(ZIP PHONE �x J�(; ��)"} <br /> :i iMo,'7G-q*I !'`1F_��}�k,•./sc.Ri. l�S3:>^o C-J�SG-h�•=.t� c7fhi µ` c <br /> � L:�.✓..1.�c.t7 ��6u3� <br /> ��! CONTR.LICENSE M tU�� �SQ Q C � <br /> U ! �?� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PHICE OF WORK ; <br /> I Electric II Gas_Other �[� �J�[j ' � � � <br /> pr-r-�r– �p���G — I � <br /> � �:: , ���; <br /> , WORK DESCRIPTION <br /> �, <br /> r� t <br /> ,. <br /> ` ; PLUMBING MECHANICAL <br /> � NO. NPE OF FIXNRE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toilet I AIC-air handling units <br /> �;�: <br /> Bathtub Forced air systems <br /> :'r:`.�. � Levatory(vrash basin) _J._ Gas piping <br /> Shower _ Water hea0ar <br /> Kitchensink8disposal _ Gasfireplace <br /> '� Dishwasher _ Gas range <br /> . Cloffieswasher _ Cloffiesdryer I <br /> � Laundry tray _ Range hood � <br /> � � Sink(scrvicelbaAmop/etc.) _ Exhaustfan / �;�� l ���� <br /> � Backflowpreventer __ Heatpump L C/ '�� �� <br /> '"�q I� _ Urinal _ UnitheaCer /` � <br /> Drinlang Fountain _ Boiler /jL�j <br /> i <br /> Floord2in _, Refrigeration J _ ;�� ; { <br /> Groase trap — wOOd�� ��`j...i � <br /> '' ' _ Roofdrains _ Other {� � .,� <br /> Other � /� -.��r <br /> — :>,hdi <br /> ; — — — ,�� <br /> 'i <br /> �' CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 ��� <br /> .*=,.� <br /> _ .. ..-�.•;s:Kp� <br /> � I hereby ceritify that I have read and examined this appliption and know the same b�he trua and corred. All provisicns oi laws and . ti,qg:y <br /> ardinaces goveming ihis type of work will 6e complied with whettier specified herein or not.The granting of a permit does not presume . �„�« <br /> tt <br /> �, ��, ro give auffionty to violate or cancel the provision of any other state or local law regulating consWction or the perfortnance of <br /> �s�.;:�f�:.. eonstructi�a Thet I am authorized by the owner of this proparty to padortn the vrorktor which application is made and I comply with the <br /> - g}a�qgctors Law 10.2 CW and 296200 WAC. <br /> %�� , �/r b /o� <br /> SignaNre of Ovme ContractorlAuNonzed ent Date <br /> . � ; _ . _.._ .. . ---- .. ____.. __. __. _---- __ _- <br />. a . . . __ _. _ _ . . <br /> � <br />�]� � <br /> i <br /> tY'tq� <br />, � � . . .. _— _ ` _ __.-, _ - <br />� .. . .. .,- _,..,_. ' __. ,,. . �. _ �.�. .�... ..,�.. _- ' _— <br /> . <br /> ....�, .—�-o ,m.q,. , —r.,.=. s. <br /> r <br /> .,�.n . . ... . . � .�_:�. � � . <br /> '�^se��"`F1` ��._ <br /> Y:'i <br />`.�..'�...�1"J �'' <br />