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.� <br /> �NERMIT APPLICATI�N <br /> CITY �DF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT.WA 98201 <br /> d25-257-8810—FAX 425-257-8857—www.everettwa.org <br /> ' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM <br /> SITE ADDRESS PARCELTAX I.D.A� PERMIT!! I <br /> 1401 t.�Elt. 0o�3'-t co►ou MoC�r,c-oa3 , <br /> LEOA L07N0.� � 9LOCK TRACi' I <br /> D63C. <br /> S$ C Y21P PHON (,,�ZS� <br /> �F. ���w►,� �,� i9�� Wu�''�.w. S� a.� �►�,°�3� cd.,o qa4 a <br /> TENANT NAME CONTAGT FOR PERMIT PHON! <br /> �F. ��+a�n+�� L P. �l Gi�va� '-t�.ss 3z8 -o-t� <br /> GONTRACTOR ��"�N`�`i�° �ooREss 3Z2o S CITY2IP PMONH <br /> CON7R IICENSE R SFA'fM1'.�.S1LWPs�� ���''ZS•S�10$ <br /> V�u'f�L'� OOc�n�►� q 8116�,3�� <br /> USE OF BUILDING � HEAT SOURGE CONTRACT PRICE OF WORK <br /> �L'}1����� I V ElcettiC �GaS_Olfier ,��p�` •3� <br /> WORK OESCRIPTION I <br /> V�wTirJC� N�.W C��r�uu—ta,1 11M,u�tir,qnti�W <br /> PLUMB M HANlCAL � <br /> NO. 1YPE OF RU(TURE OR REM NO. TYPE Of FD(TURE OR R!M <br /> Totlat A!C—eir handiing unib <br /> � Bofhlub Fon:edafrsystems <br /> � Lavelory(waah besin) ` G%.s piping <br /> � Slawer �;vater Iwater <br /> KHehen sink 6 disposal _ Gas fireplece <br /> —' DlShwasher Gas range <br /> _ Glothes wa�her .,�o Gothes dryor <br /> _ Wat¢r heffier �.O Rgnge hood <br /> „ Sink(servitelbedmop/etc.) � E�aust hn <br /> _ Backflow preventer Heat pump <br /> _ Urinet 1� UnR heetcr <br /> _ DNnkfnp Fountain Boiler <br /> _ Floordraln � Refrige2lbn <br /> Orcas¢traP Woodstovo <br /> _ Roofdrelns — p��� <br /> Ofher — <br /> CITY OP EVERETT IOGAL BA�BS TA7(CODE IS�705 I <br /> I hereby ceriNfy thal I heve roed and 6xamfnsd this appliCetion and know the same lu be lru�end corred. All provlsbna ef laws end <br /> or0in�u�goveminp thh fype of wark wi�l be eamplletl wlih whethar�pcclMd herein or not.The AreMinp of e pertnit dOp6 not prp8ume <br /> to give authorl ro vlolato or cencel the piovislon of any other stete or locel law requlotlnp conshuction or tAe perfortnenee oi <br /> �onstructlo et I em e� o ed by Me ownpr of thls property 10 perform y�e work for which applicaHon is me0e and 1 tompiy wilh the <br /> State Con rs Lew 1 CW and 296.200 WAC. <br /> �; � - — � (p � �p <br /> Signa 0 er n aoU u hzetl Agent p1e <br /> �o��` <br /> ���3 <br /> m <br />