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I <br /> P�RMIT APPLICATIOnI <br /> CITY CF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.It PERMIT M <br /> - 02 ��.uT�•-•4�� 0o �l39i i9o�3oa I�% I CiYJ (- �_ji�, <br /> ILEGA LOT NO. �LOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> OWNER ADDRESS CITV�ZIP PHONE,,.rp�p �r�� <br /> r- Y�J✓�-0 77 <br /> �� �v�e T�/�� �L L1�2 �- f�a7T tv��erT 9J�2o� <br /> TENANT NAME CONTACT FOR PERMIT PHONE y�'.��j,?�.'3 d <br /> //I.G ��.1°�l�f I ���/ITL ��r�f�� E.MAI�v`�A�n'/SAq�c.�C <br /> Zb�7TftA�f 6Sk�8 �iTPR <br /> co�i EN�P�/i�l/J!LN S�GH'�{pnS ����l2/sr/¢bC�.SC �i�J���2Or_ <br /> ��x.�iupi�-��95.24 i y2.s�.2�3d <br /> USE OF BUILDING HEAT SOURCE CONTRACT PP.ICE OF WORK <br /> / �J 1,s.��� <br /> ���'�0{� �Elec,ric _Gas_Other 3�(��41 <br /> WORK DESCRIPTION <br /> Qe�°►ce ]ti'ee �k�5�� Q��� f�+f-PG�S <br /> P�� P��s. <br /> PLUMBING MECHANICAL <br /> 'i0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet � A!C-air handling units <br /> Balhlub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water heater . <br /> Kitchen sink 8 disposal , Gas fireplace <br /> Dishwasher Gas range <br /> Clo�hes washer Clothes dryer . <br /> Waler healer Range hood <br /> Sink(service/badmop/eta) Exhausl fan <br /> OackOow prevenler Heat pump <br /> Urinal Unit heater � <br /> Drinking Pountain 13oiler <br /> Floor drain Relrigeration � <br /> Grease Irap Woodstove <br /> Rool drains Other <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby certify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br /> ordinances governing ihis type of work will be complied with whelher speci(ed herein or not.The grenting of a permi�does not presume <br /> to give authonty to violate or cancel the provision of any other slate or locnl law regulating construdion or the peAormance of <br /> construction.Thal 1 am authry ized by Ihe owner of this property to peAorm the work for which application is made and I compty with ihe <br /> Stale/Cyntractors Law 18.27 RCW and 29G200 WAC. <br /> G � <br /> �-� � �/�24f0 <br /> Signayre"o(OwnedConiractoriAuthorized Ag�nl Dat_ ��Z <br /> l� — <br />