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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—v,�ww.everettwa.org <br /> APPLfCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS ���;C�� fIl{�(i,ii YI,'�� •p�\RCELTAXI.D.N PERMITN <br /> ��;� ,. Gl,��, �!� -C�I�I 'GC'� - C � I � ) � ir�� - c�c l <br /> LEGAL •LOTNO. • BLOCK •TRACTORSUL7DIVISIONN � � <br /> o�s� �� �� ���r� ��� ��;;�.lL��,�t- <br /> OWNER ADURE55 CITYIZIP PHONE <br /> . <br /> � �"�I�� � l/ ' �C�lh��.��_y�;,;� <br /> �1��� i���l/,;�..�� ,-;1� ��1��/r;, t"1'��t. :�.�_� v> ' fl���� �z rJ;��L',/�c i�tir� <br /> �TENANTNAME I CONTACTFORPERMIT PHONE{.!;'j�t��`j;-t�/;� <br /> J ,'"{� � EaulAll•flltu �iiAit./Ui��lri'.i+�_� - <br /> -�sti-�c�rs��d� ��)t ll � � � r�=�Rs���, <br /> , — c o ✓.u;�, <br /> ��i�;',r,���v'��,�C C���'Yi'�t�i1i ��LC�;,�/'��+�� �l(��`irNf_-/f�%ii�� 5t .��/1a// � , � � -!C� //?�- <br /> CONT .LICENSEfI /��,� � � � <br /> i <br /> •USEOFBU/LDING I — • HEATSOURCE ����1,�. I CONTRACTPRICEOFWORK ' <br /> 7 �j.�i', l�i9', <br /> �"(t t L'�f �� Electric Gas _Other ;;�. "r�� � l�i>;�� �C1S� f'J, '�� <br /> WORK DESCRIPTION "� .�.<. '�,����{ �(,(,v�l�`' J-4L1.i��r�x�1 �I6ii <br /> - (��`:�i_! `> t Z.'`� �����.�1�� �l i[ GC.1 irylr� .` li : A�. / � <br /> ,k,nc��,tc7� )� r „ �r,r�,;cc�,,F,<,:t< <br /> ,, y/7�7a;;c <br /> _� .J�����;(�r �1���..� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling unils <br /> 6athlub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchr.n sink 8 disposal Gas fireplace <br /> Disbwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(service/bar/mop/etc.) Exhausl fan <br /> _ BackOow preventer Heat pump <br /> Urinal Unit hea�er <br /> _ Drinking Fountain Boiler <br /> Floor dram Retrigeration <br /> Grease trap Woodsiove <br /> Roof drains Other <br /> O�her <br /> CITY OF EVER[TT LOCAL SALES 7AX CODE IS 3705 <br /> I hereby certify Ihat I have read and examined Ihi„application and know Ihe same to be Irue and correcL All provisions of laws and <br /> ordinances governing ihis type of work w:ll be complied wilh whether specdied herein or not. The granting of a permit dces not presume <br /> to give authority to viol2te or canccl the provlsion of any olher state or local law regulaUng consiruction or the performanr.e of <br /> consiruction. That I am authorized by the owner o(this property to perform lhe work for which applica�ion is made and I comply with the <br /> Slate Contraqlors W 18.27 RCW and 296 200 A <br /> ��� / rJ /' <br /> �o-� //.��-�, / -X �� � <br /> Signat�wned`9htractorlAulhonzed Agen� Dale <br />