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- � R :RMIT APPLICATICt"�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 � 7�J3 3 � <br /> 425-257-8810—FAX 425-257-BB57—www.everettwe.org <br /> !" / APPLICATIQNS ARE ACCEPTED FROM e AM TO�PM � <br /> � <br /> 81TE ADORE8��� ��u('1/_ PARCEL TAX I.D.A PEIR>M�� 1� <br /> "t' J <br /> � <br /> LE LOTNO. r BLOCK TRACT <br /> DESC. �J <br /> OWNER M,rs�fi-a //�1DDRES� _� �E� 2 P PHONE � ,�y/� <br /> ��r��V� �I � l�:�aS�'uieic.r 9��°' <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> I Bl�"�el�c.� hcJ �zS-7s�{ - �°` <br /> conrn�cron �M�,�- DRE85 cmmP y�N�� ,�5L70 <br /> CONTR.LICEN�E LJI1 D��`fa� �S'T ���I�I� Giu�-C"�1CF�/u'b �A— <br /> �� <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eledric ✓Ges_Ottier <br /> WORK D SCF RIPTIUN � <br /> e(�6LJLeJ Z� 5 <br /> PLUMBING MECHANlICAL <br /> N0. TYPE OF FIXTURE OR IiEM NO. TYPE OF FlXTURE OR REM <br /> � Toilet AIC—air handling unks <br /> � Bethtub Forced eIr systems <br /> Levetary(wesh besin) � Gas piping <br /> � Shower Water heater <br /> � Kitchen sink 8 disposal 1 Ges fireplace <br /> � Dishwasher 1_ Ges range <br /> Clathes wasfier .l Clolhes dryer <br /> Leundry trey � Renge hoai <br /> f Sink(servicelber/mop/etc.) �xheuella�� <br /> BecMlow preventer Heet pump <br /> V Urinel --,! UNt healer <br /> _ Drinking Fountein Bdkr <br /> Floordrein _ ReMgereUon <br /> Grease trep _ �odatove <br /> Rootdreins — ��— <br /> Other — <br /> CITY OF EVERETT LOCAL 9ALE3 TAX CDDE 18�106 <br /> I hereby ceritiy thet I heve read end examined this epplica'Jon and know the aeme to be tnre and cortect. All provis�ona of laws and <br /> ordineces goveming lhis rype of work will be complied with whether spedfied herein or not.The grenUng of e pertnft daes rat Prswma <br /> to give eutherity to violete or cancel the provision oi eny other slele or bcel lew roguletlng consWcUon or Ihe perfortna�°of <br /> construdion.Thel I em euthorized by the owner o1 this property to perlorm tha work(or which eppllcation Is made end I eomphr vv�h t� <br /> State ConUadars Lew 78.27 RCW end 296.200 WAC. <br /> � /�� �� .�. <br /> Si nature o er/ ontrador/A d gent �B <br /> s ��� <br /> ,r; <br />