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PEI2MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 – FAX 425-?_57-8857 –ww�v.everettwa.org <br /> AP—P�?�ONS.AREACCEPTEDFROMBAMTO4PM �v � '�� –O� <br /> SITE ADDkESS � PARCEL TAX I.D.p PERMIT# <br /> 3 �9'r� .1c� �[dc� L5' ;C� � 3 � £�'b�l -r1Jd � ����.�' <br /> LEGAL LOT NO. OCR� TRA T OR SUBDI ISION 7f <br /> DESC. C . ZO � � _�,�C[ J �II'er�L� p <br /> pyy� DDRrSS CITY2IP PHONE ✓Z��o`77—SI Up <br /> �o.� �,�,. �c. � 7�� ��. �� �� sf. s�� cy� �.�.�,�� w�t ��a�� <br /> TE ANTNAME CONTACTFORPERMIT PHONE `�ZS Tp�J7—�108' <br /> � �A�_ O�✓�-l� � E-h!AIL�nC �I�Eu�/'.G�w. <br /> N RACTOR � �n���— <br /> �� � �_ <br /> CONI'R.LICENSE N <br /> US[OF GUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> s r � _Electric �Gas_ Olher c� ZO Q d <br /> WORK JESCRIPTIJN <br /> �� ro6 "� <br /> PLUMBING � MECHANICAL <br /> NO. TYPE OF FIX7URE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> Toil.:t A/C—air handling units <br /> E3ath�ub Forced air systems <br /> Lava�ory(wash basin) Gas piping <br /> Sho��er Water heater <br /> Kilchen sink�'s disposal Gas fireplace <br /> Dishv asher Gas range <br /> Clolhr��washer Clothes dryer <br /> Waler neater Range hood <br /> Sink (s•arvice/bar/mop/elc.; Exhaust fan <br /> Backllow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigcration <br /> Grease trap v'Joodslove <br /> I = Roo(drains = Other _ I <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TAX COf)E IS 3105 <br /> I he•�by ceritity Ihat I have read and examined this application and know the same to be Irue and currecl All provisions of laws and <br /> ordinaces yoverning this type o(work will be complied with whether spec�fied herein or not.The gr�nling o(a permit does nol presume <br /> to give authority to violat�or cancel the provision o(any other<tate or local law regulating construciion or the per(ormance of <br /> conslru�rtion-ih,�t I am autL-orized b he owner�qt Ihis property lo perform the work for wh��ch applicalion is made and I comp�y wilh the <br /> St �onlra tdrs 18. 7 RC�Y and 96.20 1NAC. <br /> � � , , , <br /> '� �, ` /v L� ZOo�' <br /> SiafiaWre of OwnedConiracl /A Ihorized Agent Date <br /> I <br /> �--- --- — — - -- <br />