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.� +r s <br /> � � _ - � <br /> � <br /> — � <br /> i <br /> PERMIT APPLICATION ` <br /> CITY OF EVERETT PERMIT SERVICES 0� �G� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> "?5-257-8810—FNC 425-25F-8857—vnv�n�.everett•r�a.org � ; j <br /> G ) `�,� <br /> APPLICATIONS AREACCEP�ED FROM E AM TO 4 PM -DEBIT&CREDIT CAROS ARE NOTACCEPTED � <br /> SI7EADDRESS � � � .,�� I PAR ELTAXI.D.p PERMITN ! <br /> /�v�o! M�+GL c�K fl�N ��6 �D� O S��- 3/ ' <br /> oesc G°rNo. s ocK rrwcr n0�� D�O (OZOO j <br /> oWNER 6 �� �� ADDRE53 CRY/LP PMONE � <br /> �F�cFM�I"�.P. 5s�o M�bvs�t�• sv�2av, saVir� G+ 92it� i <br /> TENANTNAMG CONTACTFORPERMIT � PHONE • <br /> FF A3t�Mfi/rT G P I � �Et/�LOyy 11'T L P g�.¢�7 2/L3 <br /> CONTRACTOR MDRESS CIiY/ZIP PNONE j <br /> i <br /> CONTR.LICENSB R i <br /> i <br /> USE OF BUILDINO HEAT 30URCE CONTRACi PRICE OF WORK � <br /> �.�EM'�`�//�/�.fj I �Eleclric ,_Gas_Olher I�1fJ/Q���. � 'f <br /> WORK DESCRIPiION ' <br /> /B-3 ST�Yk/71�-TM�/t"T �'u�'N65 ' <br /> a � u,� � <br /> ; � - <br /> � <br /> PLUMBING MECHANICAL i <br /> ; <br /> NO. TVf'E OF FIXT�RE OR IT[h1 NO. 7YPE OF FIXTURE OR ITEM <br /> Toiie: � NC—air handling uni� i <br /> Bathtub• Forc.d air eystems <br /> Lavatory(wash basin) • Gas m i <br /> PF 9 <br /> Shower 'fff—(,L Welerheater• ' <br /> '��o Kitdien sink&disposal • ,�'�� Gas fireplaca <br /> 78(e Dishwasher. ` Gasrange /�/ i <br /> �,(C Clolhes waslter• ,' , Clothes dryar• / ; <br /> Laundry tray ,' � � Range hood • / ! <br /> _ Sink(servicelj>arlmop/ela) !�((R Exhaust fan• � <br /> _ DackBowpreVenter Heatpump I <br /> _ Urinat .' �� Unithea � i <br /> _ Drinki,rxj Fountain �i�� ' <br /> Floyfdrain Ref' eralion � <br /> G'ease Irep adstove <br /> _ �Roofdrains � — thar ' <br /> � Olhor_ —' <br /> I <br /> i <br /> � _ . CINOPEYERETTLOCALSALESTAXCODEIS0706 � <br /> t <br /> 1 horeby ceritify that i have read and ozamined this application and know Ihe same lo he We and correct. All provisions of Imvs and <br /> ordinaces govemirg ihis type of work will ho camplied Hsth whethcr spedfieA herein or not.The granNng of a pertnit does not preaume <br /> to give authority to violate or cancel Iho provision of any olher stale or local Inw reguialing consWcfion or tha perfortnence ot <br /> conslrv ' n t I om oulhortzed by lhe owner of lhis proparty to perform lhe woik for tvhich applicaYron is made and I compty wllh the <br /> Stat ontraclo Lo 2 a 296200 WAC. <br /> 5/G-oh� <br /> Signa ura o onlractor/ ul adzed Agent �are � <br /> fvP�-M.�-t�r+�1 s Mr� i <br /> i <br />