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0: �. 30. 2Q13 6: §OAti1 <br />PERMIT APPLICATION <br />CITY OF EVEREiT PERMIT SERVICES <br />3200 CEDAA STREET, EVERETT, WA 98201 <br />425-257-t3�10 — FAX 425•257•3857 — www.everetiwa.org <br />APPI,ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SiTE AUDRESS PARCEL TAX I.O. # <br />1a�114 Ol�rw�,�c Dr _W �82U I I <br />fENANT NARI� <br />c.m'N2a�lrtq Inc. �4i5 <br />:ONTR���E� SE � Qq 5R�4- <br />USE OF BUILDING <br />WORK OESCRIPTION <br />lr�s}�c+ 11 �,��ess <br />�+o. � rvrr_ or• Fixiur�e oe irFM <br />Toilet <br />� oathrob <br />Lavalory (wash Uasin) <br />Shower <br />Hdchen sink 8 ALposal <br />Dlshwasher <br />Clotl�es H�ashor <br />�— Walerhoater <br />Sink (scrvitolbadmop/efc.) <br />Uackllow preveMer <br />Unnal <br />Dnnk�ng Fourilain <br />� Floa draln <br />� Grea,c trap <br />Hool drains <br />Olher <br />OR SUBDIVISION q <br />CONTACT FOR PERMIT <br />�eX'eif qQ; <br />NEATSOURCE <br />� Electtic _,_, Gas _ Olher <br />No.11qc7 F. ; <br />PHONE <br />(D`a0-�� <br />PeArair a <br />— (� <br />PHONE <br />42`� Z,`�11�l�� l� <br />PHICE OF WORK <br />-�2 r„ �° <br />No. I 7YP[ OF FiXTURE OR �7EM <br />NC—air handlinp units <br />Forcetl air systems <br />Gas pip!np <br />Ylalor haatar <br />Gas �irepiacu <br />Gasronpr, <br />Clothes drycr <br />Ranpu hood <br />� E_xhaust lan <br />� HCaI pump <br />Unn heatcr <br />Eluilor <br />� Rohipeiation <br />� Woodslov� <br />OU�ur <br />� <br />CITY OF EVERETT LOCAL SALES f AX CUUH 13 3105 <br />I howby ceriliry thal I havr, reatl and ezamined this application and know ihe same to he vue and conecl. Aq p�ovi;ions ol laws ond <br />oidlnatr.s govorning Ihi, type o� work wdl be complied vrith whe�hcr spocilied herein or not 1hr. prantfn� ol a pe�md Uoes noi presume <br />to pive aulhodiy to violote or cancel Ihe provision ot any olhe� stale of loCal IaH� t^pUlahnp r.atsintctiDn or Ihe per�ormorce ol <br />con;trucaon. 7het I am uuU,urized Uy tho owner ol thls propr.dy lo perfonn Ihe work tor whlch applicatipn �s made and I comply wlih thu <br />5teic Conttnclors Law � 027 PGW and 2P6.200 WAC. <br />. <br />� �.u�ti �Q_� 3o�J.3_ <br />Signa�u olOwnedCopttactorMutn ¢ ��enl Da�e <br />(� <br />Vj <br />