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PERII�iIIT APPLICATION <br /> CITY OF EVERETI' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AA1 TO 4 PM <br /> SRE.3DDRESS PARCEL TAl(I.D.+1 PERMlT N <br /> (0500 r'`q�ILL.�REEK�wy �oyOZ.0030 1300 C�_]� —Q � <br /> L[GA LOTNO. BLOdC TRACTONSUBDIVMJION• <br /> DESC. � � Z� SEALJA CE(STElZ FZVE <br /> WNER � E <br /> tv�s�+��ncw I�,eA�E4��E�ir�,s,� GDO c.wiv�aml �r s�e,� �zaG) 3ZS- 7705 <br /> �u�-r-E 28 Z6 98l O I <br /> TENANTNAME CONiAC�TzFORPEAYi PNOME �IZ,S'w�jl �j'�O�}'S'S <br /> I�EE �IT�RAF'f� I �oE� .�ISSET e�a��3�SSET��"i4aEArR.�c.r� <br /> -�bAfA��f�A- r <br /> T� K CuSSOM �-ABRICRTIon, ��Z SL� � �� SF�TL� 7p6-2q2-d19? <br /> COMA.LICENSE i �J <br /> TKGUSF� � 2017Z3 � — �� - Ud 9£'�`� <br /> USE OF BUILDING � HEAT SOURCE CONTRACT PRICE OF WORK <br /> I _ I � J O, �D�, --� <br /> Electric ✓ Gas_Other <br /> WORK DESCRIPTION <br /> �AGKl�1(� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF RXTURE OR fTEM NO. TYPE OF FlX7URE OR rtEM <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kichen sink 8 disposal _ Gas fireplace <br /> Dishwesher Gasrange <br /> Clothes washer Cbthes dryer <br /> Water healer Rarge hood <br /> Sink(service/bar/mop/elc.) _ E�aust fan <br /> Backllow prevenler Heal pump <br />- Urinal Unit heater <br /> Drinking fountain Boiier <br /> Floor drain Refrigeration <br /> � Grease trap Woodstove <br /> Rool drans _ ahe� <br /> Olher <br /> CfTY OF EVERETT LOCAI SALES TA)C COUE IS 3105 <br /> II I�ereby ceritify thal 1 have read and examined this applicalion and know Ihe same to be true and correct. All provisions ol laws and <br /> ordinaces goveming this type ol work will be complied with whether specified herein a not.The granting of a pertnit does not presume <br /> �o give authority to violate or cancel the provision ol any olher state a iocal law roguiating conslruc6on or the pertormance ot <br /> consuucuon.That I am authorized by the owner ol this properry to perfortn the work fa which applica6on is made and I comply wi;h the <br /> State Cantractas law 1827 RCW and 296. AC. <br /> � - q—�o-O <br /> Signature of .dContrac or/Aut Agent Dato 7 <br /> l/L� <br />