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PERMIT APPLICATION <br /> CITY OF EVERE77 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA '18201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa,org <br /> APPLICATION3 ARE ACCEPTED FROM B AM TO 4 PM <br /> 91TE ADDRE95 PARCEL TAX I.D.M PERMIT N <br /> o4a u�� � %P A�� 9 OoS O i� - O <br /> LEGA LO7 NO. BLOCK TRACT OR BUBDNIBION N <br /> DESC. <br /> NER A RE 9 CINlZIP E �S�9 3'(�/ <br /> � �i� w. M,«E� �yo �u�a�-P ��e C�-v�rr U�R . 98�ai <br /> TENANTNAME CONTACTFORPERMIT PMONB <br /> �.Z.S- 9'�3 " y�� / e.M�i� <br /> 61T41ZIF� <br /> A�/,��RSO� �NSrqtLqTio�J %Nc. ly/r. SMaK�^y PoiN7' BCuD, MA�tYsul�cC� wq <br /> CONTR.LICENBE N � p�ONK' 60 � 6s�� 79p� Qp•]•l, <br /> � nilJC�2 r � 96' / L.T � 3 <br /> USE OF BUILDING FiGAT SOURCE CON7RACT PRICE OF WORK <br /> s,,u�ice� ,�i9 M,� y IPns , I —���ca;c �c �asTanPr � �p a,si�s •eo <br /> WORK DE3CRIP7IDN C 4 RQa n�T r� J� �`-��95 G <br /> �Ra Ac,�yc qs' `o GS � NAua <br /> CoN7/1qC �D/L RQQG�J<A wi'rH �u¢W �K¢PLA� G Gs1S /NSQ/i7 �u�TH <br /> c�a�n.rr� � y � �N �ti . <br /> PLUMBING MECHANICAL. <br /> NC. I 7YPE OF FU(TURE OR ITEM NO, TYPE OF FUCTURE OR ITEM <br /> �I BallhWb _ �!C—air handling unlls <br /> '�orced sl�syslems <br /> Lavatory(waeh b2sin) � Gae pipinp <br /> � Shownr Water heeter <br /> __ Kllchon Sink&disposol � Oas(Ireplecn <br /> `_ Dlshw�ohor Gas rango <br /> _ Clothoe weaher � Clolhea dryor <br /> Weter hoeter _ Renge hoDd <br /> � Sink(snrviCa/badmop/otc.) Exhpusf fan <br /> Backflow pro�enler Haat puntp <br /> � Unnal � Unit hea!er <br /> �nnklnp Founloln _ poller <br /> � Fioor Araln _ Re(rlgoraGc� <br /> � Groese trap Woodetove <br /> T 'toof drains � Other <br /> � Uthor <br /> CITY OF EVERETT I,OCAL 9ALE$TAX CODE 18 J70� <br /> I hereby ceritlfy thet I have rond and examinod thls appllcetlon and know tho sama to Up true and correct. All provlslone of lawa and <br /> ordlnacea govominp this typo of work wlll bo comptiad wlth whe0ier epecttled herein or noL The grantinp o(a pormlt does not presume <br /> to givo au.honry to violate or cancol the provlalnn of any other stete ar locel lew repulxUnp opneWctlon or the performence of <br /> conslructinn. Thaf I am authorized by tho owner of thls property to perform the work for which eppllcation ia medo entl I compty wlth lhe <br /> State Con�rectors Law 18.27 RCW and 288.200 W , <br /> �T�' f /I � �� r � $ <br /> Iflnaturou Owner/ ontraetor! u orizotlApent al�e <br /> -n •.d t �sn �os ��o- t Wt� 9': DI :i�ltl;-Ci�-AON <br />