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� t_ <br /> PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810–FAX 425-25'•8857–v�nvw.everettwa.org <br /> i <br /> APPLICATIONS ARE ACCEPTED FROM B PM TO 4 PM g -9--n� <br /> SITE ADORESS PARCEL TAX I.D.p � �E,fl�MiT p <br /> ��zy P�Im A�e Cve�elt ►dA qY2�3 005'01�0o3o��d I_�U9-0I3_— <br /> LFGAL LOTNO. BLOCK TRACTORSl18�IViSIONx <br /> DESC. � � <br /> ; OWNER 11DDRE5S CITY2IP PMONE ZC�.r���_V�y I <br /> �r�rct �1m��n2rmac� � �2y Palm �z Evec-e It �IYZO3 _ I <br /> TENANTNAME CONTAC7FORPERMIT PHONE - ..���^�-'}LL-� ' <br /> L5o � <br /> JC�CC\ ��mme�mar� �<<ak �hc,rnpS:.C, e-Ma�dFc2�r�Sf�Ylir(tPt�'r;.cf_: r.Rf <br /> s8 irr�if�—�i FaF7E I <br /> Stzcl�n� Ex11'.��ur� q1D il2th�SiS Tnccru� iaA �1�'�'�'� i <br /> �h�T.lc �tchn�\cc�-� RccS�,�c�C�. i <br /> CONTR.LICENSEtl ZFj7 l�j1'�L'L�' <br /> T 1�.E 1 QC�1 GGt� - <br /> USE OF BUILDING I -- NEAT SOURCE I CONTRAC7 PRICE OF 1YORK <br /> [tec:ric __Gas__Othcr Fj ��'Fj y- t({'� <br /> WORKDESCRIPTION ��eY �CU�r � it�y�,c D� �i%t����T�"1UC1 i,�11}'�'� � �Clyl''Y' <br /> oF Camp�Si�ic(1 <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FIX7UqE Ofl ITEM N0. I NPE OF FIXTURE OR ITEM <br /> ' _ Toilei _I A'C- air h.ndling unrts <br /> '� Baihlub Forced au sysiems ! <br /> i �yvatpry(wash bflsin) _� Gas p�ping � <br /> Shower _ Water heater � <br /> Kilchen sink R disposal _ Gas fireplac= <br /> �ishwasher __ Gas range <br /> Ciolhes washer Clo�he,drycr <br /> Water heater Range hood <br /> � Sink(service�badmop�etc.) _ Eahausl fan <br /> 'i dackliow preven�er _ Heat pump <br /> � Urin.,�. __ _ Unit hcater �. <br /> I = Drinking Founlain = Bodei i <br /> Floor drain Relrgeration <br /> Grease irap Woodslove <br /> I Roof drains _ Other _ <br /> I� = OIhC�__ __ _ I . . . <br /> , CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I hereby ceritity that I bave read and examined Ihis appl�cation and kno�.v Ihe same to be hue and correct. All provisions ol lavn arW <br /> adinaces goveming lhis rype ol work will be complied�vith whether specified herein or not.The grammg o1 a permrt does noi presume <br /> to give authorily to violate or cancel the provision ol any ether state or Ioca�law regulatmg tonstmc6on cr Ihe pedormance of <br /> censlmc;ion.7hat I am authonzed'ny the wmer of Ihs proper,y to peAcrm the work tor which applicanon�s maCe antl I�cmo•y rnth the <br /> Stale Comractors l.aw 18 27 RCW and 296200 WAC. <br /> �#z��;�`��"_,��� ��`id�� <br /> S�pna�ur ,vner ontractorA� ion.ed Apent—` ate <br />