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\ � 6 S I <br /> � <br /> I <br /> PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICFS ; <br /> 3200 CEDAR STREET, EVEREiT, WA 98201 '��r �� � <br /> 425-2,7-8810-FNC 425-257-8657-vnvw.everetiwa.org , b <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T0.4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED � <br /> SITE AD�RE55 ��� PAR EL TAX I.D.# PERMIT# � <br /> /¢Gl MFJ+�RILL CJzEEl� ��6 �� [� Q / /�� I �� ; <br /> LEGA �OiNO. 8 OCK TRAC7 oO�7O �� D/„ZOQ i <br /> DESG � � �v � <br /> ONMFR ADDRESS CIN/7JP PHONE � <br /> _�F�c��s+�rc.P. ssio Mo�bvs��. svrr�2oo sa.v�r�o c,+ 9ais� i <br /> TENANiNAMC CONiACTPOR PERMIi � PHONE <br /> i <br /> Gr sS1��'�vl,�i��,P. I � �Ef��[.oHN�1►'T 6.P. 858 4�7 2/z3 ; <br /> CONTRACTOR ADORES$ CIN2IP PHONE j <br /> � <br /> i <br /> CONiR.LICENSE Y � <br /> i <br /> USE OF BUILDING HEAT 90URCE CONTRACT PRICE OF WORK � <br /> �M��L9��/�'.�-�- + �C EleGric �Gas�011rer I�.,(J�Q���.� �' j <br /> WORK DESCRIPiION �� <br /> /B-3 STc,e.Yi►�J57�T/�•!��►'T �.vttYn'65 -;2 ��( �� � <br /> i ., <br /> ; <br /> PLUMBING pnECHANICAI j <br /> � <br /> NO. TV(+E OF FIXTURE OR ITEh1 NO. iYPE OF FI%TURE OR ITE"d <br /> i <br /> Tollet • _ NC–airhandlingunils i <br /> Bathlub• Forcad uirsyslems � <br /> Lavatory(wash basin) • Gas pping i <br /> Shower 'f$—f� Weterhealer• � <br /> � Kitchen sink 6 disposal •,,'�� � _ Gas fireplaee %� <br /> Dishwasher• Gas 2nge � � <br /> 'LQ,(G CIollies washer• � Clothes dryer• <br /> ,_ Laundry Iray Rarge hood • � <br /> _ Sink(servicelyarlmop/ela) �Jt.(� Exhaust/an• i <br /> _ OackHo�vprcNenler Heatpump I <br /> _ Urinat . y� Unit hea � <br /> Drinki�g Founlain goi�� I <br /> Floofdrain Ref' eralion � <br /> _ Grease Irap odstove � <br /> ,Roof drains - thcr � <br /> � Othor — � <br /> — i <br /> — _ � <br /> � <br /> __ . GITY OF EVEHETf LOCAL SALES TAX GO�E IS 5106 � <br /> I hareby ceritily that I have read and oxamined this applicaUon and know Ihe same to Ca true and correct. All provisions of law5 and <br /> ordinaces goveming tli�s type of work will ho complicd Hith whother spedfied herein or not.The granting of a permil does not preaume <br /> to 9ive aulhority!o violale or cancel Iho provision of any olher state or loral law regulating consiruction or the pedortnence o1 <br /> consiruc' t I om aulhorized by lhe owner of this property to oerfortn the�.vork for wh(ch appiication is made and I comply wilh the <br /> 5Mte ontrocto Ln a '296.200 WAC. <br /> ' S-/G-oh' <br /> Sic�n�ureo�onlractor/7�ulFiorizedAgent ate � <br /> fv�M.�+�s Ms� <br />