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PERMIT APRLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 42�257-8810-FAX 425-?_57-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� `06_�'Z <br /> SITE ADDRE PARCEL TAX I.O.K PERMIT N <br /> I � b ��.01� t�1 � �,� 21 Z -00� <br /> IEGA LOT N.. DLOCK TRACT OR SUODIVISIUN A <br /> CESG. <br /> OWNER nooer:ss CRV21P VNONE <br /> `� �—��a�-, �A� ���q � 3�� <br /> TENAHTNAME COMACTFORPERMIT PHONE ' � �a� ��IIyDO <br /> �'^"(�'i � �Z�'� E�1AJt�IY1.1<�i%`.,4Gs'�{'�orl1 <br /> L.(�V�IA� - YV� 4 �1 � �CIT7/LP P . <br /> � P L ses�+Fl-� �� a.�6 �l e r c�r <br /> courR.ucense s �(t.f�X\`'�Aq�-� 'l-�'1 �61�6 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> S�\/ _[lednc �,as�Olhet � <br /> F—• <br /> W DE CRIPTION <br /> ��c.e_ �e,� � q o, � �Do� 1-c.,- -�- '�� ow � <br /> ��� �- �� �i� <br /> PI.UMBING MECHANICAL <br /> NO. TYVE OF FlRNR[OR IiEM NO, IYPE OF FIXTURE OR ITEM <br /> _ Tollet A/C–alr hantlllra units <br /> Ba�lub Forced air sy9tems � <br /> _ Lava;ory(wnsh bns;n) Gae o�ping <br /> ShoNer Walar heeler <br /> _ Kitchen,ink d dlsposal Gas fi�placx <br /> _ Dlshwesher Gas n�nge <br /> pottws washer Clot�es Gryer <br /> _ Wnter heater Range hood <br /> Sink(sNrva�/barlmople[c.) E#�au3t hn <br /> J_ �ackNaw pirventer _ Ileat pump <br /> Urinaf UNt hcatar � <br /> _ Drinklnp Fountain � F3oiler <br /> _ Floordwn ReMgerntlon <br /> _ Grease lraP WoodS�ove <br /> _ Raaldrains _ Olhcr <br /> OIhO� <br /> CIT/OF EYERETT LOCAL SALES TN(CODE 161705 <br /> 1 hereby certify t�at I hnHe rcad aid nxamined Mls appiication and know t�e same to be true and cortad. Ail provisions of laws and <br /> �rtlinences goveming this lype of work will be compfed wlth whether specifi�herein or not. Tho grantinq al a pertnd does nor presume <br /> to pive euthori,y to vida0e ot cancoi thw prov�cion of ony other stat»ar local law rugulating eonstruaion a the por`ortnarce al <br /> co [(ian. That I am nNh�rii d by tho ownor o(this pmpary to perhrm thn kork kr which appliatlon ie madc and I compty vnth thc <br /> SYate ontroctors Law 78.27 and 2 .200 W�C. � <br /> i /� <br /> � rT <br /> v atvre o eqControct r/ u onzed ngent D te <br />