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� "� i <br /> PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SE�iVICES � /)� ��� ; <br /> 3200 CE�AR STP.EET, EVERETT, WA 98201 �U I <br /> 425-257-8810—FNC 425-257-6857—wvuw.everelhva.org � , <br /> APPLICATION9 ARE ACCEPTED FROM 8 AM TO 4 F'M -DEBIT 8 Ci�EDIT CARDS ARE NOT RCCEPTED <br /> _ j <br /> /I�O� M�SFJ�RIGL CjrEE/� ���(jP�aR./Q�EJL/T'�AX�I�.D,#� PERM17IT# � <br /> r��_ .L li'-� d 1 f AO � ��� I '�(7 � <br /> �ecn �OT NO. 6��OCK rnncr �p�f{-�p ppp �ZpU j <br /> DESG � <br /> � -- t <br /> OWNFR ADDRESS CINILP PHONB � <br /> � �Er�L-c�1s�?L,�. 55/O MoP�fbv5EL7�., Sv/7�2ov��/A'� G1 92/t� j <br /> 7[NANTNANE CONTACTFORPERMIT PHONE i <br /> FF �v�M��7G,P. I f� �1/��o�1�JrT G.A. B5� 4�7 2/z3 <br /> CONTRACTOR ADCFiE$$ CIN21P PHONE I <br /> CONiR.UCENSBA � <br /> USE OF BUILDINO HEAT SOURCE CONTRACT PRICE OF WORK � <br /> A,�/�AE'.7�r.�1L,fl��G7 I .L Eleclric _Gas_OUie� I�.,p/����. � f ' <br /> WORK DESCRIPiION / ' <br /> /8-3 sTc.eY��'JV�7'�/� �-�'��'N65 � <br /> � <br /> � i^ [,f,^ � � i <br /> i <br /> PL�JMBING MECHANICAL i <br /> M0. TVPG OF FIXTURE OR IT[M N0. 7YPE OF FIXTURE OR ITEN : <br /> f Toliet • ^ AfC–airhandlinguniLs � <br /> � Bathlub• Forcad aircystcros � <br /> Lavatory(vrash basin) • Gas pping 1 <br /> Shower �fL Weterheater• i <br /> � FGtchen sink R disposal • ..��� _ Gas fireplace ;-- <br /> DisMvasher. Gasranga � <br /> �{r Cloliies washer• � Clothes dryar• <br /> Laundry Uay ;�' , Range hood • � <br /> _ Sink(servicelbarlmopfelc) � Exhaust fan• i <br /> _ OackRowpreventer Heatpump I <br /> _ Urinal � �� Unil hea � <br /> _ DrinhirKj Fountain Boiler ! <br /> � Floo�drain Ref' eratioa • <br /> _ 6rease tmp odstove � <br /> ,Roof drains � thar <br /> _� Glher � <br /> _ � <br /> — — � <br /> _ i <br /> . CIN OP C•VERETT LOCAL SALES TAX CODE IS J106 � <br /> I <br /> I hereby carilify that i h�ve read and oxamined this application und kno�v the same l�te We and correct. All provisions of lo�vs and <br /> ordinaces goveming this type of work will 6o complied Ndlh whetFer spedfied herein or not.The granAng of a permit daes not preaume <br /> to give authonty lo violate or cancel tho provisbn of ony olher state or local Icx regUa�in7 canstrvction or the pedortnance ot <br /> constru ' l I om outhonzed by the owner of lhis proparty to perform!ne^��otk for which applicaCron is made and I comply wllh the <br /> Stot ontracb Lo . a � 2�6.200 WAC. <br /> 5-/G-oh' <br /> Signa reo onfractod ut orizedAgent ate � <br /> f�/i°�M_A�ta�+�l s Msf <br /> I <br />