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!'�RMIT APPLICATION <br /> CiTY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810�FAX 425•257-8857—www.everettwa.org <br /> APPIICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM <br /> �ITE ADDRESS PARCEL TAX I.D.R PERMITR <br /> y01 OOE3�1 cotoo rb�o� -�� <br /> l6GA LOTNO.�' BLocK TRACT <br /> DESC. <br /> OW A DRES CITYZP ONt I�ZS� <br /> �F, t���� L�P. 19�101 �10�`�w. � � ►�►�.°�°3V c�a 9ay� <br /> 7ENANT NAl11E CONTACT FOR PERMR VNONE <br /> FF. Or�oPv►a� L P. I P.�,,1 Co�RVAtJ �-4��-5= 37�8 -wo� <br /> CONiRACTOR�—yw� �� uL. ppDRESS C�TY/ZIP PNONE <br /> 20�03 4Jpa,-suor�P�.nrti <br /> CONTR.IICENSE�M��P� IRbAR �`1Do°'"""'""", �`''z' `�Zs-k8l -�t,S�S� <br /> USE OF BUILDINa HEAT SOURCE CONTRACT PRIGE OF WORK <br /> ��( ���,� �Elechk _Gas_Other <br /> WORKDE9CRIPTION �_ <br /> 1 L V YVL�J�I�JI.! N�11� C�A�U"10hI llMlx.T���� <br /> LUM8ING HANICAL <br /> NO. iYPE OR FDCTURE OR IT�M NO. 7YPE OF FIXTVR!OR tt'eM <br /> Tollet NC—air handling unNs <br /> � Bathtub _ Foreodair,ystems <br /> Lavatory(wash basin) Cas piping <br /> Shower Weter heater <br /> Iqtchen sink 3 disposal _ Oas firoplaca <br /> Dishwesher Gas ronpe <br /> Clotheswasher ^ Clothssdryer <br /> Water heater � Range hood <br /> Sink(servlceroarfmopletc.) Exhaust tan <br /> Baekllow preventer Heat pump <br /> Urinei Unit heater <br /> Drinking Fountafn � Boiler <br /> � Floordrein � Refrlperatlon <br /> _ Grease Vep Woodetove <br /> _ Roof drains _ Olher <br /> Olher <br /> CITY OF EVERE7T LOCAI SALES 71UC CODE q 3109 <br /> I here6y certtlry that 1 h9ve rcad end examined this pppllceNon antl know the s�ma to 6e tru0 and rnrrect. AII provisions of laws and <br /> oroinaces gowmtrp Nis type of work wtll be compno0 w�th whether speclfied hcrain or not.The granting oi a pertnit does not preaume <br /> to give aumort to vlolate or cancel No provisbn of any other afate or local law rcqutating cronsVuetion or the peAortnanca of <br /> construclian al I am eu o ed by fho owner of thls propwty to poAortn thc work far which applicaUon is madm and I eomply wifh the <br /> Stete Can ors Law 1 CW and 296.200 WAC. <br /> ..�=_ ! � 0 !P p �� � <br /> Sgna o ner n c rl u orizedAgent y�e <br /> ��� <br />