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i <br /> - - i <br /> P�RMIT APPLlCA'TION � <br /> CITY OF EVERETT PERMIT � ERVICES �1�'1 ' <br /> 3700 CEpAR STRF.ET, FVEREI�', W> 98201 � /i7U i <br /> 425-257-8810-FAX 425-257-8857-www.everetlwz n -� <br /> I ' <br /> APPLICATION9 ARE ACCFPTED FROM 8 AM T04 PM -DFP_I i 8 Cr�ED17 CARDS ARE NOT ACCEPTED <br /> SIiE AD�RESS ��-' I� PAR`EL TAX I.D.71 PERh11T M � <br /> i9ot M��� �1QE6K �'�+ U6 `�(� (�C�(Z(xn/(�,/�O I �' ' <br /> LEGA �O7N0. B OCK TRACT oU�D D� O(J/ZOD � <br /> DESGf �.� n <br /> OWNER � L qDDRE53 CINILP PNONE j <br /> F��L�f�ls�?G.�. ss�o Mop�bv�E t/�. sur�Zov savsr�o Crf 92�ta j <br /> T[NANT NAME CON7ACT FOR PERMIT � PI{aNE <br /> Fr= sSv�.�'M,�! L,P. I � 9EV��oyN�'T L.P. B� 4�7 2/z3 � <br /> CONTiWCTOR ADDRESS CIT"21P PHONE � <br /> i <br /> CONiR.LICENSE s � <br /> i <br /> UgE OF BUILDINO HEAT SOURCE CONTRACT PRICE OF WORK � <br /> i��M�r�/�/�/�'•f-" I L� Eleclric _Gas_Othe: I�^LfJ/0���. � 'f 1 <br /> WORK DESCRIP710N � ' <br /> /8-3 sTc.eYk�717�7'ME/►'r £�,YtA�A'65 f � <br /> ��C t.s,i , �� i <br /> i <br /> PIUMBING MECHANICAL i <br /> NO. TYPE OF FIXTURE OR ITEI11 NO. TYPE OF FIXTURE OR ITE17 <br /> � Tailet • = NC-airhandlingunits i <br /> � Bathlub• Forcad airsystems � <br /> Lavatory(wash basin) • Ga,pping I <br /> Shower � Walerheater- + <br /> ��o IGtchen sink 8 disposal �,:'� ,_ Gas fir lace <br /> DisMvasher• Gas range � <br /> 2gfe Clolhes washer• � Clothes dryar• � <br /> ,_ Laundry tray !�. � Range hood • � <br /> _ Sink(servicelDBrlmop/ela) tl{�(� Eshaust fan• i <br /> ___ OackOuwprcNenler Heatpump i <br /> Urinai . �J� Unil hea � � <br /> _ Drinhing Fountain _ go{�� !. <br /> _ Floofdrain Reff eralion <br /> _ Grtase trap _ VyQodstove � <br /> �Roof drains � 6ther � <br /> � Othor — <br /> I <br /> i <br /> � . CITY OF EVERETT LOCAL SALES TA7(COUE IS 3106 I <br /> I <br /> I hereby ceritify that I have read and axamuiod this applicalion and know lhe same to he We and correct. All provisions of laws and <br /> ordinaces goveming tti�s type o(�voik will ho complicd��d1h v�hetFer spedfed herein or not.The gren6ng of a pertnil does not presume <br /> to give aulhority to violale or cancel tho provision of any olher stote or!ocal Iow reguiatin�cans;ruction ar the p3dortnance of <br /> conslru ' l I am uuthorized by the o�,mer of Ihis proparty to perform Ihe woik tor which appiication is made and I comply wM the <br /> Stet ontrado Le a 296.200 WAC. <br /> �—.,. S/�s�Oh <br /> Signaureo onlractod ut odzedAgent at�e — - <br /> fvr�M.�r�s .4-irr <br />