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ERMiT APPLICATION <br /> CITY OF EVERE'iT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS qRE ACGEPTED FROM B AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX LU.# PERMIT! <br /> 1'-IOl t#�K- col�o M D l-o3r� <br /> LEGA �LOTNO.� �} BLOCK TRACT <br /> DESC. `�� <br /> OWNER . AUDRESS C PMONE UZS�' <br /> �F ���oAn��n- L.� P l9yo� 4Q�nv�w.�xr� a.�o t�-t�,�,°I�°3c� �9a4a. <br /> TENAN7NANE CONTACTFORP[RM�T PNONE <br /> F� p�u��� l., P � P.y�,,► G��vAa �tzs 3�e -woa <br /> CONTRAC70R �'�N`�` � ADORk3S3'� p�— CRY21P PMON6 . <br /> , � Tl�isii.� s'r¢kca- zao•'Zs�S�o$ <br /> CONTR.LIClNSE# ��,,��� c�ooa� <br /> �WA- <br /> qellB K3su I <br /> USE OF pUILDING I HEAT SOURCE I CONTRAC7 PItICE OF WORK <br /> �11.T1�/�yy��� 1/ Elactric _Ges_Olhcr IQ Q,` '3A <br /> � 1, <br /> WORK DESCRIP110N <br /> �I�Tih1(o ��W C��,�tfV�ur.,-1orJ �1M,�x..'ri�ttvttu..� <br /> PLUMBING ECH ICAL <br /> NO. 1'YpE OF flX7URE OR REM NO. TYPE OF FURuRB OR ITEM <br /> , 7ollet A!C–eir handiing units <br /> — ���b � Forcedairsystems <br /> � Lavarory(wash basln) � Ges piping <br /> _ 3hpwer ^ Wat¢rhealer <br /> , Kttchen aink 8 disposal _ Gas fireplace <br /> Dishwashmr Gas renge <br /> � Clothes waehor � Clothes dryer <br /> _ Water hoater �'u Ranpe hood <br /> _ Sink(aervicelbaNmop/ele.) � ExAsun fan <br /> _ Beekflow prcvanter Heef pump <br /> ". Urinai � Ualt boater <br /> _` Drinking Fountain � Bo112r <br /> _ Floordrain Refrlper0tion <br /> i Groase trap VJuodstove <br /> _ Roo(dralnS -'— �o, <br /> __ Other — <br /> CITY OF EVlRE(7 LpCq�6ALE9 TAX CObE IS�tOD <br /> I hpieby corlBfy that I have road and examined this applkatlon and know the same o be we end cortoct, qll provtsions ot lawa and <br /> orotnaces govominp tl�is type o!wo�k wtll be compllad wiu,uvhathor speclfied Aerel or not.Tne prantinp ot a pertnit does not pr�ume <br /> to gwe eutho' to violata or ca�cel mo proNslon of eny other state or local law ieg iaung con�fiiction or the perlortnance of <br /> conatructio at I am au o "ed by the owner of this property ro parfarm tho vro for whlch spp�kaHpn(y made and I comply wifh the <br /> State Con rs Lew 1 CW and 296.200 WAC. <br /> .- � f �, o (�. <br /> Sl�ne eo er on aornuttrorize ge� ete <br /> J\. o <br /> 3� <br /> \ ��� <br />