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. r <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 320U CEDAR STREET, EVERETT,WA 98201 p <br /> 425-257-8610—FAX 425-257-8857—wuvw.everetlwa.org (� �l b `l � <br /> pPPUCATIONS ARE ACCEPT'eD FROM 8 AM TO 4 PM ���'�'�� <br /> SITE ADLIRES3 PARCEL TAX I.D.i P,�RMIT i / <br /> 3y5 Hea-fher Roacl OOIoObI-O00-0�3-00 �-' ��S " D/� <br /> LEG LOT NO. BLOCK TRACT OR SUBDM&ON t <br /> DESC. �3 View R'cl e �C�I7�70�L- � ����tt <br /> OWNER ADDRESS CITY2IP PHONE <br /> �►1icl,ae,l Th.�mto✓Z BSOa. Si,arlor� lclon r. Eve��.tt ��25�903-a <br /> TENANTNAME CONTACTFORPE /'rydQ �HONE ,rj(��8/8-��ol <br /> I l J�,c�`'-- <br /> ���12en rrnT E�AaLI7Cfl70�'�1S0.ICi/t�917�0.�I.0 M <br /> CONTR.LICENSE/ i./�/I�C� <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S'iny l e ��Mi/y Q¢S��C�P�'t CZ _Elactric �ee_Other O'� � <br /> WORKDESCWPTION �- �F-move. mascnry �,�cPkic¢. S uw�t ce���n cnen-i2 qrec� roorn 57aSnFT� <br /> Z_ Wdd tns.ilatiOn {n WI a�ior wa.115�etl,lln9, $ floor Cbelow <br /> re.t �oom� <br /> j-R�p\n.ce. oc-�5�na\ w;ndoWS 4 a�1d Skyl��+ (c�11 En_.r�y Sta�- �un-�'�fiec�) �9 <br /> H-Run us �;nzs fer �;.-2pVnc¢s $ ro+��qe with ba1o5�. <br /> 5-Mcd��� Sta�r�,.�e.\I �olnF.reas�: F�ea�c-oom� r��place 1 Wa1l <br /> v-CLap\u b K��chen H kill�ey arers 10 �rurc.t tu:r'r.�t 3rnndnrd5. ,-0�r aut d �nsul4t2 remain; <br /> _ ,�„_,� z.< <� �.�- � r�wstec- "a{M HANI AL a�ls. <br /> LUMBING <br /> NO. 7YPE OF FI7(TURE OR ITEM NO. TYPE OF FUfTURE OR REM <br /> �j> Toilat•- add AIC-air handlinp unNa <br /> c�;y Bathtub-a<1c, Z Porced air systems <br /> Lavatory(wesh oasin)-n.dd 5 Gea piping <br /> �, Shower-a<ld � � Waterheater <br /> � Kitchan sink 8 diaposal- re��a��- a Gaa fireplace �D <br /> � Dishwaaher-r�p/ace. � Gas range <br /> Cbtheswesher _ Clotheadryer <br /> Water heater Renpe hood / <br /> v E�fiaualfan5 3- SOCFr+t <br /> � Sink(service/bedmoplatc.)-adcl � �_rvuerrov.�✓e ov�N r.l�BW�'r 1N <br /> _ Backfiow preventer (j'1 _ Heat pump L �,p�,,.i �Kt�nCToa FAN <br /> Urinel I _ Unit heater <br /> Drinking Fountain _ Boiler <br /> F!oor drein _ Refigeratbn <br /> Grease trap _ Woodstove <br /> Roofdrains _ Other <br /> � Other F-rE ToR Pu_MP — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceAify that I have r�ad and examined this applicatlon and knowthe same to be Uue end coneet. PJI provisiona of lawa and <br /> oNinances goveminp this type of work will be complied with whether specfiad herein or not.The prantinp of a pertnil doee not pieaumo <br /> to give authority to violate or cancel the provision oi any other state or local law regula6ng conatrudion or Me perfortnance of <br /> construcUon.Thet I em authorized by the owner of this property to perfortn the work forwfiich application fa made and I t-0mpy witli 1he <br /> Slale Vadors� 1 27R�1A1� 298.2 WAC. � �!� <br /> SignaW ot OwnedContracto Authorized Agent �e (� <br /> �d- <br />