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- . � . � � � : <br /> ( <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org -��. /'3 �/O <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM rn ���7�c-' <br /> SITE ADDRESS PARCEL TAX I.D.t PERMIT M <br /> �Q�o �����i �� T�4�y 2�0�02 L oU50b <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION A <br /> DESC. <br /> pDDRESS CITY2IPQ.�y,o' PHONE <br /> OWNER , �n��•� <br /> �v�-�jfu�l'P-�� �a(d►��S' L.(.-G 'L2310 20'�' A�C. SE. q 80'L-1 <br /> TENANT NAME CONTACT FOR PERMIT PHONE/LQ — 76 j� <br /> �/1�CG I ���1f�' ���� e�a� l��l�tl'�� �ew6 �VAC. <br /> 0 <br /> -�A (-'t��a�e�-s� �eFa� 'l fcl�'�� �a b -76 3 I�yu M <br /> CONTR.LICENSE M�� y�r�Q � 11�(,(��' / L 7 J' 1'�K,�/OY� f�; Lv� <br /> K-�, �� �l � <br /> 11 <br /> USE OF BUILDING I HEAT SOURCE CONTRACT PRICE OF WORK <br /> �Electric Gas_Other �R�� ��� <br /> �R�DESCR�PTION��� ��vA� u,,;h onz �uct/Q55 $�I�Fs�S<E••� s{�C �'Wo �3 , o�e �oo� �oor,Q <br /> � !/ � ! <br /> p�G �tu�rirji�cr� Grs Jt�s �iQi^�', <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet � P✓C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) � Gas piping o.�Fl�fS <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clothes washer _ Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/moplelc.) � Ezhaust fan <br /> Backflow preventer I Heat pump <br /> Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drain _ Refrigeralion <br /> Grease trap _ Woodstove <br /> Root drains Other <br /> Other 1 �"�"� ' � <br /> — ! P n hoo <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> I hereby certiy that I have read and examined lhis application and know lhe same lo be true end correct. All provisions of laws end <br /> ordinances goveming this type of work will be complied with whelher specified herein or not.The granting of a pertnit does not presume <br /> to give aulhority to violate or cancel the provision of any olher state or local la�v reguleting constructi�n or the performence of <br /> construclion.Thal I am authorized by the o er of this property to perfortn the work for which application is made and I comply with the <br /> State C racto w 18.27 RCW and 296. WAC. � � <br /> i �^ i <br /> Sign re o nerl o lorlA horized Agenl Date � <br /> Z <br />