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. � � , <br /> PERMIT APPLICATION �-0�S <br /> CITY OF EVERETT PERMIT SERVICES S y��(T <br /> 3200 CEDAR STREET, EVERETT,WA 98201 � <br /> 425•257-8810-FAX 425-257-8857-www.everettwa.orp a��'-6 ; <br /> G <br /> APPLICATIONS ARE ACCEPfEO FROM e AM TO 4 PM �b�d � <br /> SITE ADDRESS PARCEL TAX I.D.� PE • <br /> 30� � <br /> LEOA �or No. s�ocu rn�cr oe susonmon• 7u J� ,a, <br /> DESC <br /> �ti.,���'rA�vAn-ncs p o. /Joh Ai. to6 ti0� 'FE4 SI <br /> — T <br /> TENANTNAME �ONTACTf011PEMAR PMOME <br /> I L )��- � c���'`�a����,. <br /> eoAn�u. <br /> E�nG� s:. �►%' •.v�� Zlao P�f<< .a� � 4�2.i 2sa -3i�y <br /> ('1NTR.LICENfE• <br /> O <br /> USE OF BUILDINO MEAT 80URCE CONTRACT PRICE OF WOR <br /> JOy��! %�72.¢�Y I _Electric a0ae_Other <br /> WORK DESCRIPTION �y�� � G�P�P��,� <br /> /.'YS"r�?6L (�2� 5' 7°n. Ro uF�vP ?/R��E'.9�'El� <br /> ` u <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FUfTURE OH REM <br /> Toilet A/C—air hendlinq units <br /> Bathtub � Forced air systems <br /> leva:ory(waeh besin) � Gaa pipinp <br /> Shower _ Waterheater <br /> Kltchen sink 6 disposal _ Gas fireplace <br /> Dishwasher _ �a4 nnpe <br /> Clotheswasher _ Clothe�dryer <br /> Water heater — R��90� <br /> Sink(servicelbedmop/etc.) — ���s��� <br /> BecMlow preventer Neet pump <br /> Urinal � UnH heater <br /> Orinkinp Fountein Boiler <br /> Fioor dretn _ RefriperaUon <br /> Grease trap _ Woodstove <br /> Root dreins — �� <br /> Othar — <br /> CITY OF EVERE7T LOCAL BAIES TAIf COOE M�10f <br /> I hereby cerltity that I have read antl ezamined thia eppllutlon and know Ma Nma to bs Vw end cortect. All providont of laws end <br /> ordineces poveminp this type of work will be complied with whether tpedfled Mroin or not.Ths prandnp of�psrtnk doet not prowme <br /> to give authority to violate or cancel the proWslon ot eny oMer ttete w IacN I�w ropul�tinp conttrucLon or tM p�Aortnana ol <br /> construcUon.Thet I am authorized by the owner of this propeRy to psAorm tM work for which applialbn is made and I comply wiM lhe <br /> State Co ors w 18.2n7 RCW,��and .200 WAC. <br /> /�� _ �/�: Y;�O� <br /> gneture o wner/ ontractod ut onze qent e1e ,I <br /> L <br />