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oaizsi•�oi� mon �a:a� r•:�s azs a�s ;oas w,� �❑�urut cns �ooiiooi <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98?O1 <br /> 425-257-a810 - FAX 425-257-8857 -vuww.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM 'l ��� —!� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> zz � .- ��� C�.v� �r 3q � �r-� � �z�- � �a � i� � 3 n 4- 06�- <br /> I.EGAL LOTNO � BLOCK 7RACTORSU6DIVISIONA <br /> oeSC �1� <br /> OWNER ADDRE55 CITY2IP PHONE <br /> 221 � --�o�,���Qo�-� 1:�.�2. ��' ZO � c.�,c�'�y��3 5� <br /> T N NT NAh1E I CONTACT FOR PERMR PHONE <br /> SL� EddA1L <br /> cor+r ct niil�n_i�..., � >j,��„�nhs ADURE$ ��/S-w • 2l�—N o Ey25 3�t7•/� y <br /> a � ��-"..��, /� r, <br /> CONTR. LICENSE J� ��� �JC'�j L�4�� �A <br /> /��t1/it/E�9/3 G/.� 98'20� <br /> US[OF BUILDING I — H[AT SOURCE I CONTRACT PRICE OF WORK <br /> Electric Y Gas Other �2�7 2 � <br /> — ✓ l/i <br /> WORK DESCRIPTION �/� <br /> ���(j�i2Q.L �-L�Cty�L,�� {�+2� n , <br /> / <br /> PLUMBING MECHANICAL <br /> NO. TYP[OF FIXTUNL OR ITEM NO. IYPE OF FIXTUR[OR I7ER1 <br /> _ ioilcl NC–air handling unds <br /> _ Fiathtu6 � Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> _ Shovrer Waler heater <br /> _ Krtchen sink P,disposal Gas freplace <br /> _ Uuhwasher Gasranac <br /> _ Glothes washer Clothr.s drycr <br /> _ Waten c�ater Range hootl <br /> Sink(service/bar/mop/r.tc � [rhaust fan <br /> _ OackfiOw prevenfer Hr.at pump <br /> _ Uiinnl Vnit heatcr <br /> _ __ Diinl:iny fuunidin BpiIP� <br /> __ Floor dram Hefnqeralion <br /> _ Greasc Irap �---- <br /> i Routdrain; — Woodstove <br /> — ����e __ Olhcr <br /> GN OP EV[RBTi LOCAL SALES TAX COD[IS 11D5 <br /> I hmeby cerlity Ihaf I have r�ad and examined Ihis apphcalion and kno�v Ihe same to be Uue and correcl. All provi;ions of law,and <br /> ordmances governinc� thi,type of work will bn comphed wdh whether speciGed herein or noL The granting of a pem�it does no!presume <br /> lo grve aulhonty to violate or cancel the prowsion ol any othrr,late or 10031 la•,v regulaling consfruction or Ihe performance of <br /> ¢lrucbon Th�l l am aUthonzed by lhe ownEf of ihi5 property lo pe�lorm Ilie work lor vihiCh appGca6on is maAe and I comply wilh ihc <br /> , Ac CoMrzctors I.aw 10 27 2CW antl 296 ZOO WAC. <br /> , �-�� � z� o <br /> -�r���.�._ �__ � 3 <br /> S�9nalure o1 Owner/CoMracfor/�uthonzed nryn_nl �- � U��� <br />