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i _ - _ _- — <br /> ---— --- --- <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM b AM TO 4 PM <br /> SI��DRE�. Mar�ih:. VieW �1f� J�� I Z 7PA ) IL7AODE�7- �� PERM)T� ` . <br /> ,.� <br /> LEGA l0T NO. BLOCK TRACT OR SUBDIVISION p <br /> DESC. � <br /> i <br /> OWNER'r II OI11 I ADDRESS CRY21P PlfONE !rj<i S� " O/O � <br /> I <br /> Mn���' ���rluu - 7z �E, .M��,�;�. v���w a�ti�� #l�E��,�++ w� >���� I <br /> TENANTNAME CONTACTFORPERMR PHONE Q2S> S�Q� C}�y'O � ` <br /> �.*� r..� I�� ' �I�S ,`I�P1�II�� e�a� Gr/<SC�uI�tML�L plSl�• v <br /> �tir� >> 'r Iu�ub�n3 ����,1 1�'ir''ir�1 -,9�� S Na IUn 1,;, � � d- I <br /> � ��I P� 4 ..� AN��y 1 9�s ) S!-1 <br /> CONTR.LICENSE M <br /> 047 590 ����'KS1'i191c g�'��� �7�C <br /> USE OF BUILDING HEAT SOURCE �°NTpACT PqICE OF WORK I <br /> �S�c�.I r}� � � U n� -�- I _ei�i�o Gas_Other " Z���'�`— <br /> WORKDESCRIPTION r��s I�y� •� }1�,+W ��/Q �OC� <br /> �u�� ���✓ � S r�'c... : <br /> I <br /> �� PLUMBING MECHANICAL � <br /> N0. TYPE OF FIXTUflE OR�TEM NO. TYPE OF FIXTURE OR ITEM � <br /> Toilel NC—air hanoling unils <br /> Balhlub Forced air syslems <br /> Lavalory(Hash basin) � Gas piping <br /> Shower W ater heater � <br /> _ Kitchen sink k.disposal Gas lireplace <br /> Dishwashe� � Gas range <br /> I _ Clolhes washer _ Clothes dryer I <br /> Waler healer Range hood <br /> Sink(service�bar/mop'elc.) _ Exhaust lan <br /> Backllow preventer _ Heal pump I <br /> _ Urinal _ Unit haaler I <br />' , _ Drinking Founlain Baler <br /> Floor diain Relrigeration i <br /> Grease Irap _ Woodslove i <br /> Rool drains _ Other ii <br /> Olher <br /> iCITY OF EVERETT LOCAL SALES TAX CODE IS°105 I <br /> i I hereby ceritity Ihal I have reatl and ezamined this application and know lhe same lo be true and correcl. All provisions ol laws and I <br /> � ordinaces goveminq this type ol work will be canplied wilh whelher specilied herein or not.The granting of a pertnil does nol pesume <br /> lo give aulhorily lo violalo or ca el the provision ol any other slate or local law regulating consWction or the perfortnance ol I <br /> conslruclion.Thal I am autho 'ted by the owner ol this properry lo perlorm the work lor which applicalion is made and I compty with the �,, <br /> Slale Conlraclors Law 18 RCW,�nd 296.200 W�C. I <br /> j � L�'--� �G s Zv� 9 <br /> , SignaWre o OwneUConlraclor/Authonzetl Agent ate <br /> I � <br />