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-: -, --, ,-., .�, _. .-�-- <br /> PERMIT APPLICATION ` �� '` !, `` ` ; <br /> CITY OF EVERETT PERMIT SERVICES :_ ;. ?pp�: <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 �_/6_09 <br /> SITE ADDR SS PARCEL TAX I.D.R PERMIT! , .� <br /> 5��1 I���+ ,I v� u�� �u��� 6 �1 oz ,�'�' ; �-�;�- <br /> LEGA LOT NO. BLOCK TAACT Ofi SUBpVIS10N i <br /> DESC. <br /> OWNEH ADDRE55 qTYTP PHONE <br /> I�.eilu la+K- �-1i7 �,�Psr�v�v� �ue►i� ��8ao3 �a5-3yy 5y�1 <br /> TENM NMAE FW(TACTFs,�PERMR� ��E$00-97�f��f5b�� <br /> ti I� `J(�CCI dJa.l'Ii�IS E.�NJ�wlWafe�`1 ou � a/i •o»»� <br /> W ASN ING�TO►� !UA i E/L�/�A� 1�pX'1I Ckc�r S G(��+g� 7$'— <br /> CONTA.UCENSE v�` � � " �� <br /> _�L�,� qc� �P P�lle vc� G�a 9�a5 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> r�51C��i�i-�a�l I _Electric LGas_Olher ��-/aa�"� <br /> WORK DESCRIP'T10N <br /> C{�������� ��cf l �rr�s Zval��� �-(Qa-� G✓ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. 7YPE OF FlI(TURE OH ITEM <br /> Toilet _ NC—air handling units <br /> Batlitub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Z Walerheater <br /> Kilchen sink 8 disposal _ Gas tireplace <br /> Dishwasher _ Gas rangc <br /> Glothes washer _ Cb�hes dryer <br /> Waler heater _ Range hood <br /> Sink(service/badmop/e�c.) _ Exhaust fan <br /> Dackflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking fountain _ Boiier <br /> Floordrain _ Retrigcration <br /> Grease Irap _ Woodslove <br /> Rool drains _ Olher <br /> Other — <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritity thal I have read and examined ihis application and know the same to be�me and covecL All provisions of laws and <br /> ordinaces governing lhis lype of work will bo crmp�ied wilh whelher sp^cilied herein or no�.The granting of a permit dxs not presume <br /> �o give authority to violate or cancel the provision ol any other state or local law regulating consiruction or the peAormance of <br /> cons�mction.That I am authorized by Ihe owrlqr ol lhis property to pedorm Ihe work for which application is made and I comply with the <br /> S�ate Gontractors Law 1627 KCW and 296. Oo wnc. <br /> _ ..����cu' l.�-iC�Cc�ti��-�-J 'f- ��-C� <br /> , Sig at e ol Owne trayt Aulhonzed Apenl Date <br />