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F � <br /> wERMiT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDFtR STRtET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-vwuw.everetr.�+a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS GARCEL TAX�.D.p PERMIT M <br /> 1�101 t� c�oL3ti�ooc_�cucalov (V1,G(�OL -G2a, <br /> LEG LOTNO. DLOCK TRAtT <br /> o��. � 1 <br /> ,�oau �� uZs_ <br /> �F. �.��i��ur L,P. lq+aoi 40'��w.� � w�,°�3vi ce-a 9�va <br /> TENANT N�!;c CONTACT FOR PEItM1T PHONE <br /> F.F. O�oPn�- L P I P.�.1 �O��,vA�) 4Zs= 3Z8 -o-ta7 <br /> CONIRACTOR ��pN`•C e ADDRE�S ?)'�ZO S CfT1'21P PHON! <br /> THi4'f1.� 3?9��' Zd�•7LS-S3lo$ <br /> COMR.IICENSE N `'��,���n�V1,t�t �A'RI.�.�W�F <br /> I.MJNl4 O���Ig t13� <br /> USE OF BUILDING NFAT 90URCE CONTRACT PRICE OF WORK <br /> �J�'T'��'{�yy�l� I Y Ekdric _Oas_Other t�� Q�� • � <br /> WORK DESCRIP710N <br /> V�i�r�nlc� IJ�.�J �a►.�,u-,o+�.l lY►'I.u�T���w <br /> PLU G MECHANICAL <br /> NO. TYPH OF RIXTURE OR ITEM NO. TYPH OF FIXTUR[OR ITEAI <br /> Toltat A1C—alr hantlllnp unita <br /> Bothtub � Forcedalrrystems <br /> � laverory Nveeh basin) _ Gas pipin0 <br /> Shower Wekr heater <br /> Kikhan sink 8 dlsposal Gas flrepl�ce <br /> Dishwashor � Gas rangc <br /> � Clothes washer � Clothes dryer <br /> _ Water h¢ater �O Range hocd . <br /> Sink(eervicsl�admop/etc.) �Q E�aurifan <br /> � 8ackllow prevQnler Heat pump <br /> _ Utlnsl Z UnRheater <br /> Ddnkinp Founyin 6oiler <br /> _ Floordrain � RehiperoNon <br /> _ Greasa trap , Woodstove <br /> _ Roof dralns _, Other <br /> Olher <br /> CITY OF EVERETT LOCAL SAI.E6 TAX CODE IS�105 I <br /> I hereby csritlty lhat I have read and examined this appticatton enA know the same to be tn,e ana comece. ntf provisions of Iaws end <br /> ordinaces govomtny this type ot work will I�compllod wtM whol�er epecMled herein or noL Tho granUng ot e permit does not presume <br /> to give autho ro vblete or cancel the provi�ion of any other stato or local law rogulaUng construction or the pertortnance of <br /> constructlon et I am au o ' ed by thc owner of thls property to perTortn thc work tor whtch applitalion le made and I tomply wl�h thC <br /> SYate Con ors law 1 ,CW and 298.YOO WAC. <br /> �; <br /> � � b a � <br /> ignat e o er on ctotl u onz gent p Q <br /> .�Y <br /> `,0 <br /> O�0 <br /> �� <br />