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' i <br /> PERMIT APPLICATION ��' <br /> CITY OF EVERETT PERMIT SE�VICES � ll ���[� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 aPR � 9 2009 <br /> 425-257-8810—FAX 425-2fi?-8857—www.everettwa.org . .... <br /> • . ...... <br /> APPUCATIONS ARE ACCEPTED FROAA 8 AM T04 PM ���OF EVFRE�"••" " <br /> E�9�neer' 17 <br /> SITE ADDRESS PARCEL TAX I.D.#� � pERMIT X � 6 <br /> ' fle rm��f� c� v0 yo�� a��c�� 'NI c -� � <br /> LEGA LOTNO. BLOCK iRACTORSUBDMSIONN - <br /> DESC. <br /> OYVNEH ADDHE55 CIIYldP PNONE <br /> �-i� ��- ��� E1/IG,,�r7Cz. l,��yu,��rmv�f /��'E £G'�ir�/ `)S',1�i 9�5 „1�`ti�-/�71 <br /> ro�utr N��� I corrrncr Fore P�nxr �+o►��� 97£f-85i� <br /> c _ <br /> `!'�t nn ` ,S� e�aJ7oTwat�,<</" 6tc�2 u�D ��M <br /> i,vas h�•�p�,�, i,c,�u�t�-,- �Cc �s Q�� � �� � E &�- <br /> CONiH.LICENSE"p • I���/��KL'� G(fQ �QO S <br /> L��SK1��9sa o j� y76-�S$� <br /> USE OF BUILDING� HEAT SOURCE CONTAACT PRICE OF WORK <br /> ���j(��i�,����(' _EleclriC �Gas_Olhe� � ���� <br /> WORK DESCRIP'T10N . <br /> ��l �ar��cje 6�-tl � G�,�����i— /u�� �Cr � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF Fl7(TURE OR ITEM NO. TYPE OF R7(TUpE OR ITEM <br /> _ 1'oilet A/C—airhandlhgunits <br /> _ Batntub Force�fairsystecns <br /> _ Lavatory(wash Sasin) — ���� <br /> _ Shower � Waterheater <br /> _ Kilchen sink 8 disposal Ges fireplace <br /> _ �ishwasher Gasranpe <br /> _ Clothes washer Clolhes dryer <br /> _ Waler heater — p�� <br /> _ Sink(service/bar/mop/etc.) Ezhaust fan <br /> _ Backflow preventer Heat pump <br /> Urinal Unit healer <br /> Drinking Founlain Boiler <br /> _ Floor drain Rehigeration <br /> Grease trap y�p��p� <br /> Roof drains — p��� <br /> Olher <br /> CITY OF EVEflEff LOCAL SALES TA7C CODE IS 3105 <br /> I hereby cerilify that I have read ami examined Ihis applicatlon and know the same to be hue and cortect. All provisions of laws and <br /> ordinaces governing ihis type of work will be wmplied with whether specified herein or noL The granting of a pertnit dces not presume <br /> lo give authoriry to violate or cancel Ihe provision ot any olher state or local law regulating conslruction or the peAortnance of <br /> consiruction.That I am aulhorized by the owner of thfs property to pedarm ihe work lor which applicatlon is made and I comply with ihe <br /> Slal Coniractors Law 182 RCW and 296.200 WAC. / .� � <br /> � �l.l�� � �t��_ ���I � �iCI_ �� � � � <br /> Signa ure ol QvnedConhadodAulhorized Agent Date � � <br />