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PERMIT APPLICATION <br /> CITY OF 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 ��a��7 <br /> SITE ADDRESS I pARCEI TAX I.D.!� PERMIT p <br /> 5 _ xAvrC(L �IH� c�J3� 1 co o � -ou <br /> LEGA LOiNO. BLOCK TRACT <br /> oesc. �t� OOO D-DD Cl� -�L I - L{�VA 1V 2— <br /> OWNER ADURESS CITY2IP PHONE <br /> C-C-.c�(��� Sc,Nu(�M�lUn� 4;,2.�1 E X�v�� - W��p CUEP��T �1� ��� <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Sc.N�Crw�'� C�C.c��GG D��b���lb2_ <br /> CONTRACTOR 7 A�DRESS CITY2IP PHONE <br /> ��NC-2- <br /> CONTR.LICENSE# <br /> USE OF BUILDING HEAT SG�RCE CONTRACT PRICE OF WORK <br /> _ 1�4� i C'1"1 �L I v0 <br /> 5 '�l'� _ _Electric _Gas�Olhar � 2�Oo <br /> WORK DESCRIPTION r <br /> `�EP��2 ���c--N L!�UtJb� '�DOhn YI-�L- - M6VC./A�� <br /> �PLUM�}Nl� -j0 ��� '`Q���f , S1NK � LF�U, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I Toilot A/C—airhandlingunits <br /> BathWb Forcod air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> � Shower _ Waler hoater /e� <br /> _ Kitchen sink&disposal _ Gas ftreplaco I� ,�P <br /> _ Disliwashcr Gas range <br /> _ Clothes washer Clolhos dryer r � ,l�J7 '� <br /> Watorhoaler Rango hood l „ V � <br /> _j_ Sink(service/badmop/elc.) � Exhaust fan �, <br /> _ Backflow proventor _ Heat pump ( . <br /> Urinal Unit haater y <br /> _ Drinkin�Fountain Boiler ��0" <br /> Floor drain Refrigeration <br /> Groase Irap Woodstove <br /> Roo(drains Olher <br /> Olher <br /> CIN OF EVERETT LOCAL SALES TA7C COUE IS 7105 <br /> 1 hereby cerilify Ihat I have read and ezamined ihis applica�i�n and know the samo to bo true and correct. All provisions of laws and <br /> ordinaces govorning this typo of work will bo complied witY whether specified herein or not.The granting of a pertnit does not presumo <br /> to give authorily to viol o or canccl tho provision of any olher stale or local law regulaling constniction or the pedormance of <br /> consWction.That I authorized by lho owner of this propi�rty to perform the work for which application is mado and I compiy with the <br /> Slale Co lra ors 18.27 RCW and 29�.200 WAC. <br /> "' •�=3•4 <br /> Si re o wnedConlraclodAulhorized Ac�ent Date <br />