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_ n <br /> PERMIT APPLICAT�ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT t <br /> 1401 � f�l� O�E3Lt coeaacoloo I I'G6ot - o�' <br /> LEGAL LOTNO.� 1 BLOCK TRACT <br /> DESC. <br /> NER ADDRESS ��n�P PH g NZS„ <br /> �F ��,�w►,� �,� wyo� �o��w. S� � �.,�,�3v c�.,o-9ay a <br /> TENANT NAME CONTACT FOR PERMIT PNONE <br /> �F. P�Zu�.�oPvKfFu►- L� P I P.b�+tti1 Co��vA�D '-}Zss 37-s -a-ta7 <br /> CONTRACTOR��,�,,� R��� �,,,�, ADDRESS � CITYZP PHONE <br /> yol b3 I.�»-SAa-t. 2�». � <br /> CONiR.UCENSEe��L�� kJoonrrq/fluL� °/i�,o�L I <br /> �� I <br /> USE OF BUILDING I HEAT SOURCE i CONTRACT PRICE OF WORK � <br /> �� r�„�,,,�� V Electric �Gas_Other I <br /> �-�rin <br /> WORK DESCRIPTION <br /> T1N���Co_ I��.1�J ��r¢�tc,�—torJ IIM,�x--riFA�r►ti�u-( <br /> PLUMBING � MECHANICAL <br /> NO. TYPE OF FIXTURE OR tTEM NO. TYPE OF FU(TURE OR ITEM <br /> Toilet A!C—air handling unils <br /> Bathlub Porced air systems <br /> lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> � Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Cblhes washer Cblhss dryer <br /> _jj� Waterheater Rangehood <br /> _ Sink(servicelbadmop/etc.) ` Exhaust fan I <br /> Backflow preventer „ Heat pump <br /> Urinal UnN heater <br /> � Orinking Fountain Boitor <br /> = Fleordrain Refrigeretion � <br /> Greasetrap ^ Woodstove <br /> Roof dralns Other <br /> Other i <br /> GITY OF EVERETT LOCAL SAl.ES TAl(CODE IS 3705 <br /> I.hereby ceritify that I have read and examined this applieation and know the same to be true and correct. Atl provisions oi:aws and <br /> ordinaces govvrning this type of work will he compqed with whelher specHied herein or not.The granUng of a permit does not presume <br /> to give authori to vlolate or cancei tho provisfon of any olher st2te or local law regulating construction or fhe per}ortnance of <br /> construdion at 1 am au ' ed by the owner of this property to perForm the work for which applicatlon is made and I eomply with the <br /> State Con rs!aw 1 CW and 296.200 WAC. <br /> � ` � � � � O�� <br /> Slgna e o er onl ctorlAuthorized Agent ate ��' <br /> �� I <br />