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� � , <br /> ,. _�. <br /> �ERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> C�^ �^\ 425-257-8810—FAX 425-257-8857—w�vw.everetriva,org <br /> ,..� rt. � <br /> / APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCCL TAX I.D.# PERMR 8 <br /> INOI t�t-r,l� »t�000cUc�loo I 'D(a�-ozi <br /> LEGAL LOTNO. 9LOGK 7RACT <br /> DESC. ._ .-..'�', 4 <br /> W AODRLSS �--Cl�titp O <br /> F.F, (�����n- L, P 19yo� 40�`� w. � a.8a t�.,�.v� °Ro��e uzs- <br /> ,�NA�N�.E , , _ ce��-9aNa <br /> CONTACTFORPERMR PHONE <br /> F� L P Co� vA 1+zS 3�� -c�-ta� <br /> CONTRACTOR u'• r.,_ �. - wK'f�fA�G rK. ADDRlSS cITYO:Ip pHONE <br /> �...v�.C�, <br /> corrrR.��c�s�. �nJ4.v/F P� t`If� �R <br /> U9E OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �n�vr� v Eieehic �Gae_,Other I <br /> WORK DE3CRIPTION � <br /> ��'�G311►� ��W �A�V.uG�OY� 11N�,lX..TIFAtN�IU.( 1 <br /> PLU IN6 MECHAN CAL <br /> N0. 7YpH OF FIXTURE OR ITEM NO. TYPE OF fU(NRE OR ITEM � <br /> Toilet r AIC—air handling unRs � <br /> Bathtub Forced alr s��stems <br /> � ShowerY(�sh batin) ',� GBs plpit�p � <br /> _ IQtcMn sink&dicposal _ Water heater � <br /> Dishwaeher , Oasfireplaco I <br /> � Clothes washer _ Gas range <br /> Z Waterheeter � Clothesdryer <br /> Renge hood <br /> Sink(xorv�ce/ypdmoplelc,) ,_ Exhaustfon <br /> _ Back}lo.v preventer Heat pum <br /> � Orinking Fountain _ Unit heater <br /> � Floor dnin _ Baller <br /> GroasY trap _ RehlQ2ratlon <br /> ,_ Roof dratns _ W�Cstovc I <br /> ,_ Other _. Olher <br /> i <br /> i <br /> Cm OP EVEREI7 LOCAL SALES TAX CODE IS 7105 � <br /> 1 hercby cerltly tha��have read and ezaminetl this applicetion and krrow the eame to be true and corroet. qll provlabns of lew~T <br /> ordinaax goveming lhia typc of work wiil ba complied wHh whethar epecmed hercin or nat.The prenUnp of a pp�N tloes not presuma <br /> ro piva autho to vtolate or canevl Ihe provialon of eny other 51ate or looal law ragulaunp construcKon or the pa�rt,��e of <br /> �°^e�y� t I gm au ed by Ihe owner af this proparty to perfortn tha work torrA�ich application Is made and I comply wlth the <br /> S�ate Co ors Law 1 CW and 296.200 WAC. � <br /> `,.�`_ ' � ° � � <br /> gna •o e n oror Authorize Agent <br /> aie \ <br /> � <br />