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/ i <br /> t <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �' a y �� <br /> 3200 CEDAR iTREET, EVERETT,WA 98201 . „ <br /> 425-257-8810—FAX 425-257•8857—www.everettwa.org (l;�::;;.�� -�) <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PARCEL TAX I.D.p PERMIT N „ <br /> SITE ADDRESS � '? <br /> ,C oOv �6W I—T �l E Sr2. ����' ���� <br /> LEGA LOTNO. BLOCK TRACTORSUBDIVISIONM <br /> DESC. <br /> OWNER AUDPESS CITY�ZIP PHONE y/�f— - <br /> i o�u k"Gw�rT�v E E�-,�~f cvt� 98•�yY,-'/ <br /> TENANTNAME CONTACTFORPERMIT PMONE 7�vB <br /> ' � I V(JC 1 E•MAIL �GL7� <br /> f� :GG/ �� 9i�� p[. Nc �'�,� �,�,cA. .�2 <br /> � L/f/EF EQuiP�7G-+� � <br /> CONTR.UCENSE k /� y / yZ��y�r- 2��7 <br /> f -F�� 1,P�f11� <br /> USE OF BUILDINC I HEAT SOURCE CONTRACT PRICE OF WORK <br /> __Eleciric _Gas_Olher � Y3(�J, GG <br /> WORKDESCRIPTION U �i H9 � �/ N�-"-� SU i�j � VL,30J,t�i <br /> ,BY Eu�,i,.-,.��n.�� ���t��C�J e���Ns,f'NE� v�E,P Aii�/��51- i,.�f;�CCi,,.�G/��`' <br /> �� 3em �_��z s1Sz,.1 -ra' P,��er v-�E �PPc ��acs d-c�w^� �NE q.u�ur <br /> .rn /�jfC�i THE �uC-;S Pt6��N^ f��-�S. �F r'�-�SdJC 5�.5,2--rn rJ/CLT/F /^'�"' +� E <br /> Qti1�aC f .5�� S f - I C SNU' ee1�.� e E .i c� m• <br /> PLUMB NG ECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI7(TURE OR ITEM <br /> Toilct _ NC-air handling units <br /> �alhtub __ Forced air sys�ems i <br /> Lavatory;wash basin) _ Gas piping <br /> Showcr _ Walerheater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Di�hwashcr / _ Gas range <br /> _ Clolhes washer r ;` � __ Clothes dryer <br /> N'ater heater \J . _ Range hood <br /> Sink(serviceibadmoµ�e�c.) 1 �I� ' _ 6xhaust fan <br /> = Backllow prevenier 1� �i,� _ Heat pump <br /> Urinal �q (� � ��ti� _ Unit healer <br /> Drinking Founlain � ` '1� _ �oiler <br /> _ floordrain ( ((���� ��l ._ Relrigeration <br /> � Grcase Irap (�J 1 � `�� _ �Noodslove � FfSie., <br /> — Roofdrains ` 'i � l _ ther-•f7r�f/��.,SC� <br /> O�hcr \ — <br /> I� CITV OF EVERETT LOCAL SALES TA%CODE IS 9105 <br /> I hereby ceritify thal I��m,aA nlid eaamined this application and know the same to be true and correcL All provisions ol laws and <br /> ordinaces governipg9jr��i�e ol�vork will be complied with whe�her specilied herein or not.The granting ol a permit does not presume <br /> to give aulhoriqfoY(�5�e or cancel the provision ol any olher stale or local law regulating consimction or ihe pertormance ot <br /> onstructio9!f l f9 am aulhoiized by Ihe cwner ot Ihis property to pertorm the work for which application is made and I comply with the <br /> Stale Co dr rs Law 1d27 RCW and 296.200 WAC. <br /> I .� � � �7-O �I <br /> aturc of OwnenCon raclodAulhorized Agent ���� � <br /> /i �� <br /> I'-------------- - -- - — —� <br />