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..... . ._. ... ._. ... _ � ' __ __ .. __._' _ _'. _ __ �.. . _._ _ . . <br />L <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />A25-257-8810 - FAX 425-257-8857 - www.evereltwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />_fv�vi��vc, r•:• <br />l0T NO. BLOCN TRACT OR SUFiDIVI510N R <br />DESC. <br />uo n� � H �n1,�ro �� �—Y� M����.e �t ue <br />TENANT NAME CONTAC7 fOR PERM�T <br />I[.�¢v/Io,�r�J �urLz.�.2 <br />CONTR.UCENSEk <br />USE OF BUILDING <br />�m�� <br />WORK DESCRIPTION <br />p <br />��f/.��� �!?3-3Y7-3983 <br />PNONE3�'U 3I$'7-Y3.�-Z <br />E�MAIL�JI�I)a,�j �(%�j�:�,; <br />:ITY21--- P �N �G_�� <br />cap�mp-,���s y3�1 <br />(Oo2�� <br />HEATSOURCE <br />_ Electnc _ Gas _ Olhe� <br />�ns�u � � �, � s � / �- �c �P•� <br />PLUMBING <br />NO. I TYPE OF FIXTURE Ofi ITEM <br />� Toi�el <br />6athtub <br />Lavalory (wast; basm) <br />Shower <br />Kitr.hen sinA 8 disposal <br />Dishvmsher <br />Clolhes washer <br />Watei heater <br />Slnk (serviceR�admOp/etc ) <br />_, �ack0ow prevenler <br />Unnal <br />Drinking Fountain <br />Floor dran <br />_ G�easa trap <br />Rool drains <br />Other� r �— �/� <br />_L ��[/I.t^�It]Lt�i3Ci'T <br />CONiRACT PRICE OF WORK <br />��ry6. o0 <br />NO. TYPE OF FI%TURE OR ITEM <br />NC - air hand6ng wuts <br />Forced au syslems <br />Gas piping <br />Water heatei <br />Gas fireplace <br />Gasrange <br />� Cloihes dryei <br />Rangelwod <br />E-xhauslfan <br />t leat pump <br />Umt healer <br />�o8er <br />_ Refrigcration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TA% COUE IS J105 <br />1 hereby certdy thal I have read and exammed this app6caM1on and knuw Oie same to be Irue and correct. A�I provisions ol laws and <br />oidmances governing Ihis type of woik will be compHed wilh whether specified hemin or nol 7he grenlmg of a permil Aoes �iot presume <br />to 9�ve authonty lo violate or cancel Ihe piovision ol any other stale or local ta�v ieg�lating constmctron or Ihe performance ol <br />construchai That I am aulhorized by the owner ol Uus property lo periorm the v.�ork (or �vhiGi applicauon is matle and 1 compty with Ihe <br />Slate Cnpjr�clors,F]ativ 10 27 RCW and 29fi.200 WAC <br />