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�` a <br /> I�ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.evcrettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 91TE ADDRE93 PqRCEL TNC I.D.i1 PERMIT 0 <br /> �-101 f�lE1L OOE3�'t fo100 �'!0 0 I -Da. <br /> � LEGA LOTNO.� � 9�OCK TRACT <br /> DESC. <br /> NER . SS !LP PNONE (�^LS� <br /> �r.F O��-�.otVn�r L�� 1940� 4��au�w.S�x� � w►»�.°�03� te�9�4�.. <br /> . TENANTNAME CONTACTFORpERMR �MONE <br /> Frr. ��oPrN(EAl�' (..• P I � l.:•IF.JA� �"1'ZS 37� `U-tCp <br /> CONi1tACTOIt ��N`.C�C, ADDRE55 j�,'1p �j CITY2IP PMONE <br /> TuiSR.� sr¢�c� 2oto•'2r-�3�0$ <br /> CON7R.LICENSEN "��,�f ,y n�y1,1�1 �-��W.} <br /> 11 i� M IN,JN�4 q8118 k35 � <br /> USE OF BUILDINO I HEA7 SOURGE I CONTRACT PRICE OF WORK <br /> �)�J(.,T1�/{��� �Electrie Gas OthQr ,� �1�j , �� <br /> � <br /> WORK DESCRIPTON <br /> V�h�TI►�1Co ►�1�.k1C,o►a�"�U1orJ lYY1,u�TiGt»��W <br /> PLU 1 G ME ANICAL <br /> NO. 77PE OP Fl%7URE OR REM N0. TYPE OF FIXTUR!OR�TEM <br /> Toilet AIC—air hnndlirtg untts <br /> _ Bothtub ! Foread air systems <br /> _ Lavatory(wash bnin) r Gas piping <br /> _, Shower WaterMeater <br /> Kitchen sink 8 d�sposel _ Gas fireWace <br /> _ D19hwaSher Gasfange <br /> I _ Clothes washer � Clothes dryar <br /> _ Waler heater � Range hood , <br /> S�nk(corvlceJbarlmoplelc.) E#isust fan <br /> � BackFlow preventer Heal pump <br /> _ UAnel � Unit heater <br /> , Orinkinp Fountain _ Boilsr <br /> _ Fbordrain � Refigerethn <br /> Grease trap Woodstove <br /> _ Roof dreins _ p��r <br /> � Other <br /> CT'OF EVERETT LOCAL SALE6 TAX COOE IS 3105 <br /> 1 hrreby ceritty�het I hav9 read end examinad Ihis applitadon and knaw tha samo fp btt We end correct All provictons of I�wa end <br /> ordinaces govaminp thte type of worh wlll b�camplisd wkh wholher spvcifiad hcroin or nOC The grenting oi e pertnh tl0o5 nOt pre�ume <br /> to give autho to vlolpte or cpncel Ihe pmvlsion of any other state or local law repulaUnp conshuetion or the performsnce of <br /> consMictlon at I am eu o' ed by the owner of this property tv perform the woAc for wh;ch applicallon Is mede antl I comply with the <br /> Stato Co on Lew 1 CW ana 296.200 WAC. <br /> ignat o 0 on ctor ut o zea Agem ! � a p � <br /> �01,�� \ <br /> �r,0 <br />