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-- - _ _ _-__ . _ -I <br /> � - PERMIT APPL.l�ATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y-� 7--D � <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> � /� <br /> �IG�G � Ci✓ �� ��`�cOa �9C7�!'aS ) UUULZdZ'> (J1U'�l-\ C1"I <br /> LEGAL LOTNO. BLOCK 7RACT <br /> DESC <br /> OWNER ADDRESS CITY2IP PHONE <br /> -�i'��cel �G� rci�y •io 'i t/�-ccv �� • lCcc.cct� ��S�v� �i.?S��Z-�2. -y�J`i/ <br /> . n�� TENANT NAME nCONTACT FOR PERMIT PNONE <br /> '�'�i�"� � �l� (1� � ��iLl.lclr�n �iU�s� 75t�c%-r'! 7� �� 51 �f <br /> ��-�1�.� CONTRACTOR �/ ADDR SS . �7 •� .�.�. CITYZP PHONE . - .� ._ <br /> II'°.u� �C�/�SH�h'i�7t�) �t��$T� �'+"5�.� y1 �{� �T� �)� �. <br /> �l '' --- ���cf4i 7 K _ <br /> ��> <br /> , C-� �.l ,,, �15�-Y��'�' <br /> , � � conrR.uc�sea �, � ., <br /> . , , <br /> � •! CU95NZ�X" iS�l(.'l� � _ � <br /> USE OF BWLDING I — HEAT SOURCE ���1 CONTRACT PRICE OF WORK <br /> T � <br /> Glednc Gas Other C<'�� �`�-` ' <br /> I WORK DESCRIPTION � a � I <br /> i �r l�,z,�.� �'z�F- �%� ,.�C�e �� c CC.'��5�' %� /L%���t�� <br /> PLUMBING MECHANICAL <br /> I Np, TYPE OF FIXTURE OR ITEM NO. NPE OF FI%"NRE OR ITEM — <br /> Toilet NC-air hai.dung units <br /> �athtub __ Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ bValer heater <br /> Kitchen sink&disposal _ Gas fheplace <br /> Dishwasher _ Gasrr.nge <br /> Clothes washer _ Clothes dryer <br /> Laundry tray _ Range hoc.+d <br /> Sink(servicelbar/mop/etc.) _ Exhaust fan <br /> Backflowpreventer _ He2tpump <br /> Urinal _ Unilfieatei <br /> Drinking Foun�ain _ Boiler <br /> Floor drain _ Re(ngeration <br /> ' Grease trap _ Woodslove <br /> Roof drains _ Other <br /> �I � Olher ��il - ' � - ���� — <br /> I <br /> (:ITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> �� I hereby centify thal I have read and examined this application and know the same lo be lrue and correct. All provlsions of Iaws and <br /> 'I ordinaces goveming ihis type of work will be complied vnth whether spedfied herein or oot. The granting ol a permit does not presome i <br /> � to give authority lo violate or cancel the provision or any other stale or local law regulating construcUon or the peAormance of <br /> � constmdion.That I am authorized by the owner of this property to perform the work for which application is made and 1 comply with the i <br /> '', State Contractors Law 1827 RCW and 296200 WAC. <br /> � ��� �tU'��,v� ��A�l�L1 . _,� �-�-1�'T_J� � � <br /> SignaNre of Owned.omractor�h6nzed AgeN. � Oate <br />