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� ��RMIT APPLICATIC�.J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.evereitwa.org / ► �� �-?� <br /> vi � <br /> � �J APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 'T <br /> SITE ADDRES� a�huc�L Qa PARCEL TAX I.D./ i �ERMIT�� � <br /> i jv� <br /> LE LOTNO.�� BLOCK TRACT <br /> DESC. <br /> OMMER � � !//�DDRE7v� NE�I 2 Ip pHONE � +/Yy4A <br /> � I�S�G�icr 9��' <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I �l"P.tt'�(ic �/ heJ �15-75�/ - (` <br /> CONiRACTOR DDRE9S �m21P PHON ,,/7O <br /> h�Qma�� / �[ s�2d= Sa • �- <br /> CONTR.UCEN$E�T,��`f`Q'u 7�T ! s' ��I� Giu�[,�1oWci'e �A— <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> I _Eledric ✓Ges_Otlier <br /> WORK D SCF� RIPTIUN � � O! <br /> I�., _.'_ V l <br /> e(�LJLeJ �J <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FIXTURE OR ITEM ND. TYPE OF FlXTURE OR REM <br /> ,� "fdlet A/C-efr hendling unNs <br /> � Bethtub Forced eir systems <br /> Lavetory(wesh besin) � Ges piping <br /> �• Shower L, Waterheeter <br /> � Kitchen sink 8 disposel L Ges fireplece <br /> � Dishwesher ,_[_ Gas renge <br /> Clothes washar 1 Clothes dryer <br /> _ Laundry tray _1- Renge hood <br /> Sink(servicelber/mopletc.) �xheual fen <br /> Beckflow preventer Heet pump <br /> � Urinat Unit Mater <br /> � Drinking Fountaln � Bdler <br /> Floor drein _ RefigereUan <br /> Grease trap _ W�dstove <br /> Roof dreins — �8� <br /> Other — <br /> CITY OF EVEHETT LOCAL SALES TAX COOE 19 J/06 <br /> I hereby ceritiy that I heve read and exemined this application end know lhe aeme to be true er�d cortecl• All provislons of lews�r�d <br /> ordineces goveming lhis type oi worlc will be complled wilh whether spedfied hereln or not.The grentlng of a pertnK does twt Pro+�e <br /> to give aulhority to violale or cancel the provision o1 any other stele or locel law regula8np conaWctlon or the performenc°ot <br /> construction.That I am euthorized by the owner of this properly to perfortn 1he work tor which applketion Is mada and I comWY`��8 <br /> Stete ConUadors Lew 78.27 RCW and 296.200 WAC. <br /> � � ,c_-_ �� � �I 7 <br /> 5 gneWie o erl ontrector/Authorized Agenl ate <br /> ,� � <br /> . � ' , <br />