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-- ___ � _ __- <br /> _ _---- — - - --, -- --- - <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVI�CES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810–FAX 425-257-8857–www.evereHwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�1 PM <br /> SITE ADDRESS '�JG J� ( �C('T I G PA�EL TAX I.D.11 PERMIT It <br /> S GSIZ-(�G� <br /> LEGAL LOTNO. BLOCK TR/1CT <br /> DESC <br /> OWNER 11DDRE55 CITYZP PHONE <br /> n„�i� C,ciuCujc��� I�C�. ��zC�i-�iG LVefQ�� ��201 `f�.S :��S-ni1 �0 <br /> TENAN7NAME � I CONTACTFORVERMIT PHONE <br /> `�und l�nct:no� � -rt� r,,� Luif �{�-5-''�S>,-�I173 <br /> CONTRACTOR ADDRESS CITV/AP PMONE <br /> s.�,n-C�- �u:�r�c` �wai eve��3�.�c�� t,ya,�) I�•� �/ tve� el� �1�s�� �( <br /> CONTR.LICENSE N��p�.�..4 <br /> `�e--�-�'��I APo �[. n1 �oc/yoP> �las-353- �1173 <br /> U3E OF BUILOING I — HEAT 30URCE I CONTRACT PRICE OF WORK <br /> Electric Gas Other �C� � � <br /> WORK DE3CRIPTION �S'�]�I �y�� ''>(��Y�l�,.t71 C�(,�..) L��I�G �iYU'Y� ��f�� :• �O `�id�. <br /> ,;� b1.,�lr�.+ �� _N ;,� - �1�� +� , < <�l • -�� i•-e, ci��,�lticd 1'� ;�elc o� <br /> �'� ����v� �.,,-!H -� Frtic+ �.�'n.i �r_{heSi�a_ . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FI%NRE OR ITEM <br /> Toilet A/C–air handling units <br /> Dathtub Forced air systems <br /> Lavatory(vrash basin) Gas piping <br /> Shower Water heater <br /> Wtchen sink 8 disposal Gas fireplace <br /> Distiwashor Gas ranpa <br /> Clothes washer Clathes dryer <br /> Laundry tray Ranpe hood <br /> Smk(servicelbarlmopletc� Exhaust tan <br /> Backflow preventer Heat pump <br /> Unnal UNt heater <br /> Dnnking Fcuntain Boiler <br /> Floor drain Refrigere6on <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CIiV OF EVERET7 LOCAL SALES T�%CODE IS 3105 <br /> I hereby cei6fy ihat I have read and examined thls app6cahon and know tha same to be We an,i wrrecl :-�.4 provisions of laws and <br /> ordmaces gavemmg tliis type of work x�ll be comphed with whether speafied herem or not.The granting ot a pertnd does rrot p�vsume <br /> to give authonty to vaiate or cancel the provisron ot any other state or lowl Izw regulahng construction or the performance o1 <br /> construcBon Thet I am au�honze 6y the owner of this property to perform trie work for which eppliw0on is made and!compty with'die <br /> State Cnntrada�Law 18.27 RC and 29G200 WAC. / <br /> .� <br /> - .. (1..5 <br /> gnah�re ot ner/Con cto/A nzed Agent ate <br /> I L� <br /> � <br />