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� PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 42E-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AN, TO 4 PM �� ���� <br /> SITE ADDR[SS PARCEL TAX I.D.# PE T H <br /> 3041 Kra�n� 14vc, /O 5����- <br /> LEGAL LOTNO. BLOCK TRACTORSUBDNISION# <br /> UESC. <br /> OWNER AODRESS CITYRIP PHONE <br /> �iob gr �e� 3oyl �Cr�vne� f�}Je.. F�e�tf 9�1a-ol la�- 33o-9301 <br /> T[NANTNAME I CONTACTFORPERMIT PHONEI' <br /> �1�'S� ``�00� <br /> N w TOl1l{ �0.�Q0✓O E•Ma� 1/Ifo�J feoFl <br /> CONTRAC <br /> 8aley 12�ot�.�,T,.,c. P.o,B�c $a�-�c� kenr,s�. 4a -8ob-aoo� <br /> CONTF;.LICENSE q R$0 a,� <br /> , 6►4�-e Y r�T R3a Qz <br /> USE OF eUILDING HEAT SOURCE CO�TRACT P ICE OF WORK <br /> re$i ��4�i.� _Electnc �Gas_Olher � � !{- . � <br /> WORK DESCRIPTIOY <br /> Ieo.d' o�F t re�ta�-e., YYmfl � W� nraa C.av�-P. <br /> PLUMBING MECHANICA <br /> � NO. TYPE OF FiXTURE OR ITEM N0. TYPE OP FIX7URE OR TEM <br /> I <br /> I _ Toilot _ AIC—airhandnnguniLS <br /> Bathtub Forcod airsysterns <br /> Lava�ory(wash basin) - Gas piping <br /> Shower Wafar hoa�or <br /> KitChEn sinL-.&disF�Sal Gas flreplace <br /> Dishwashe� Gas range <br /> Clothes washur Clothes dryer <br /> Watan c�otar _ Range houd <br /> Sink(service/tar;'n:op/etr. Exhaust tan <br /> i Backllrnv preve:nter Heat pump <br /> Urinal unit heater <br /> _ Drinking Fountain Boiler <br /> Floordrpin Fefrigera� n <br /> ._ Greaseirap WoodSl9 C <br /> � Roof tlrai O1hB1 <br /> Other . <br /> I <br /> I ciTv oF eveaen�ocu sa�es rnx coo�is a�os <br /> I hereby certity thal 1 havo read and ezamined this applicaGon and know Ihe same to be true and correcL All pwvisio ot laws and <br /> Ofclin9rlces floveming this�ypn o(work will be Nmplied with whether spocifiod heran or not.The granting pf u permit oes not prosume <br /> I lo give aufhonty to violate or cancel the pmvision of any olhw stale or local law reguleting construdion or the porform nce of <br /> � eonstruclion.That I nm aulhorized by the owner of lhis property to pedortn Ihe work for which applicaiion is made an I comply with the <br /> Stale Cont ,ct\Law�827 RCW and 296.200�VAC. <br /> ���__� �I- I �_I I <br /> Si nawr ol Ow edCont todAulhorized A ont Dete <br /> � <br />