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,�: V, �.�. Lr L �. � �:'y' �1". i:'.�'� . L <br /> PERMIT APPLICATION ; <br /> CITY OF EVERETT PERMIT SERVICES ', <br /> 3200 CEDAR STREET, EVC-RETT,WA 98201 I <br /> � 425-257-8810-- FAX A25-257-B�i57—�v�v�v.everettwa.orp <br /> APPUCATIONS ARE ACCC-PTED FROM 0 AM TO 4 PA7 I <br /> I PARCEL TAX I.D.M PERh11T# � <br /> SITE AUDH[SS <br /> i � � oo� -, on,�5�i rnlzi l -oy-�— <br /> LEGAL LOTNO. DLOCK <br /> TFIACT OR SU�DIVISION lt ` <br /> Uf:SC. <br /> OYJNER AU�HESS CITY2IP PNONE <br /> �LI�� 1 m c►/o o, — - --1�1 eu,1 ; `OY rvC�rekl� '-k�-��-� <br /> 7f NANT NA�d[ <br /> I cor�rncrFonruara ' ri�owc I <br /> B•61AIL I <br /> COt11HAGT08 AU SS CIIY/ZIP PHONG <br /> C11� I-4� n� <br /> CONTR. ICENSH p � <br /> ,* ,� W�S�o�ula �-v Y - vJ a ao� -ce <br /> USE OF�UILDING I — HE�T OURCE CONTf1ACT PRICE OF\VOfiK <br /> Electric�as_Otfar � I�d�_0� <br /> wonK oescnirnoN <br /> PLUMBING MECHANICAL <br /> ��0. TVPfl OP HXTl1RE UR ITGId NO. TYP[OF FIXNII6 OB I7EL7 <br /> Toilet A/C—air handling unils <br /> — Forced air syslems I <br /> Lavat ry(��ash basin) � Gas pipiny <br /> I � Snower = Wuterlieater <br /> Kdchen slnk&disposal Gas lireplace <br /> Dishwasher Gas ran�e <br /> C101hes w�5hef _ C101hes dry0f <br /> Wa1cr heater _ RMge hood <br /> Smk(service;bar/mopletc.) ExYiaust�an <br />^. J Backnowpreventer _ He2lpump <br /> �Irinal Unil healer <br /> Drinkinp Fountain � eolier <br /> FioorCrain � Reirigeration <br /> Grease trap _ Woodslove <br /> I = Rool cirains _ Oiher <br /> Olher _ I <br /> CIiV OF EV[RE7T LOCAL SALES TAX COU[IS 9105 I <br /> I hereby ceritify Ihal I havu road antl eaamlr.etl Ihls appfca;ion and kno�v the samo to be true and cuuecl. All p�ovisions ol laws and <br /> ord�.naces governlnp this type o�work will be compi�ed�uth whother specitied hereln or nol. rne g�aniing o�a permR tloos not presuma <br /> Io�7iva aulhodly to v�olale or cancel the prov�sion of eny othar stale or local law regulating con5lNclion or the peflotmance o� <br /> 'I tonsliur,tion.Thai I am authorized by the owner o(ihis prOpeny to peAorm the work for which application is mado antl I comply�vith the <br /> St e o�Ir3ctors La 1827 RCW and 296200 WAC. <br /> .� " a I <br /> Sign3lure UI 0� ner�Con ractcdAuthonzed Agenl ate <br /> I— — <br />