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Jun 11 10 02:10p p.1 <br /> i � — <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX d25-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AIiA 70 4 PM p ��I �LU <br /> SRE A�DRESSZ3DS ORKES RVE PARCEL TAX I.D.A pERMRtR <br /> �UO ll'' C7 <br /> CEG LOTNO. 6LOCK TRACTORSUBDIVISIONt <br /> DESC. <br /> OWNER ADDRESS n � GITY/LP PHONE <br /> CNF_RYLYiIlN C. II��a�//�1 23�5 OfIkES oh� EVE2eTT 425.87�9.BSBB <br /> TENANT NAME CONTACT FOR PERNpT PHONE¢� 3$9 ��-QS <br /> L� 7 <br /> 1.7, �' !-1 N►�.Y E-MAIL aPFi�YC�Cauras;.�, <br /> �. r�. �',N+�v��vcra. r�c. Bgos-:,�}�'Av. l..J. ►�/1.��,"-�n 1n/� Hz� �5�1.zs9s <br /> CONTR.L]CENSEM � ` �// q�Z�— <br /> L71�`�11�1L.1 l/� 1�� //i h <br /> USE OF BUII.DING I H�`AT SOURCE I CONTRACT PPoCE OF WORK <br /> _Eleclric Gas_Other <br /> WORK DESCRIPTION <br /> 1�f_'MaL1I'ronJ qF �)45,—in.,c� dlou•Lo�.ezaQN4/A,� GAAAG �L <br /> PLUMBING MECHANICAL <br /> NO. 7YPE OF FlX7URE OR REM NO. TYPE OF FI%7URE OR ITEN <br /> _ Tdlet A/C-air harWli units <br /> _ Lavatory(wash basin) _ Forced air sysle�ms <br /> Shower _ �s piping <br /> _ Kilchen siNc 8 disposal _ Water heater <br /> Dishwasher _ Gas fireplace <br /> Clothes washer _ Gasrange <br /> Water heater _,_ Clolhw dryer <br /> Sink(serviceJbaNmop/etc.) _ Range hootl <br /> Backllow preven;er ._ �hausl ten <br /> Urinal _ Heat pump <br /> Drinking Foun!ain __ Unit heater <br /> Floordrain _ Baler <br /> Grease trap _, Refrgeratlon <br /> Roofdrains _ Woodstove <br /> Other _ Olher <br /> CITY OF EVERE7T LOCAL SALES 7Alf CODE IS J10.S <br /> I hereby certiy that 1 have read and e�mined Ihis applicatfon and know;he same to be true arxl correcL All provisions of laws and <br /> ordinances yoveming Ihis rype o`work��II be comp�ied wifh whethar specified he:ein or not.The granting of a pertnit dces not presume <br /> to give authonN ro vialate a cancH tne provision of any other state or bcal law regula6ng construction cr the per,'ormanoe ot <br /> construdion.7h t I a uthorized by the ov.ner of this property to pertam the work fpr which application is made and I wmply with the <br /> State ConU r 8.27 CW and 295.200 WAC. <br /> Signalur p( rmet/ ntraC( r�AU;hOrrzetl A enl � �� D <br /> � ate <br />