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P <br /> I �ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320p CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857-wVvw,everettwa.org <br /> APPI,ICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> 31TE ADDRESS PARCEL TAX I.D.fF pERMIT# <br /> (401 �C OpE3�t C�x�coloo �a�oi-on� <br /> LEGA L07N0.� � � BLOCK TRACT <br /> DESC. <br /> ��R ADDRESS , CITY2IP PMONE <br /> NZS— <br /> 1'r.F, (�U�nAnt�r L,P. l9yo� 40�'m€ w. 5�xr� � �� °�3� �9aya. <br /> TENANT NAME CONTACT FOR PERMR PHONE <br /> FF. Orwr�o� l.. P I P�t+�►J �i�vAa �-i�Zs= 3�8 -a-to� <br /> CONTRACTOR��� /1 _ _ _� ��L' qpDRESS cITY2IP PXONE <br /> YUAN,01 ��o� ��.�H �� <br /> CONiR.UCENSER p - ����� ��2 �7r– �'IvI ' �SS'S <br /> �bC '� ��� <br /> USE OF Bl11lDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> rnUL'�1. FfiM4All� v Elechic _Gas Other <br /> WORK DESCRIPTION <br /> �ww�gr� 1�1�.�rJ G��rvNu-�a.l `1M,u�.T«m.�W <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FlXNRE OR ffEM N0, TYPE OF FlXTl1RE OR ITEM <br /> Toilet WC–air handling units <br /> BathNG Forced airsystems <br /> , Lavatory(wash basln) � Gas plpinq <br /> Shower Water heater <br /> � Kftchen sink&disposal � Gas firepiace <br /> Dlshwasher � Gas renge <br /> �t> Clothes washer Clothes dryer <br /> �p Waterheater ` Rangehood <br /> Sink(service/bar/mopletc.) � Exhaust fan <br /> � BacMtow preventer Heat pump <br /> ,� Urinal —' Unit heeter <br /> Drinking Fauntain 8oiler , <br /> _ Floordrain � Refigeratton <br /> Grease trap — yy�pdy�p� <br /> � Roof drains Other <br /> 'I ,ther . — . <br /> CITY OF EVERE'R'LOCAL SALES TAX CODE IS�105 . <br /> I hereby ceritify thet I have read and examined this application and know the same to be tnie ar,d corrnct. Ail provisions of iaws an�' <br /> ordlnaces goveming th!s type of work wlil be complled vrith whethor specfied heroin or not.The granting of a pennit does not presume <br /> to give authori to vlolato or cencet the proviston of any other state or locsl law reguladng construction or thapertortnance of <br /> construclion et I am au ' ed by the owner of lhis property to perfarm tha work tor whlch application is made and I comply with the�� <br /> State Con ors Law 1 CW and 296200 WAC. <br /> .,._.—... � � n � �� - o <br /> Signat e o er n ctoNAuthorized Agent e�e � O\p <br />