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Mar-15- 30 10: 14A P .O1 <br /> _. .. _ _—_' _ . _! _. ._ .— '—' ._ � <br /> PERMIT AF�PLICATION <br /> CITY OF EVERETI' PERMI7 SERVICES - % , <br /> � 3200 CE�AR STREfT, EVERETT, WA 9820t <br /> �725-257-8810- FAX 425-257-8857 - www.everettwa,org <br /> , APPLICA710N5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I� SITE ADDRESS pARGEL TAX I.D.A' pERM1T i! <br /> .� �O � C'P/e ��,_arr ��—e _ ILic„'�-uij <br /> LH;id LUT NO. eLOCK TRACT OR°UBDIVISION p � <br /> i 11FSCI ._ _-- �. . <br /> UWNER ADOftESS ^ � GIN�ZIP pHONE � �� I <br /> �4,�r,.•_���� �Iq�f�' .?f 70 7 C�� f.»��.-� �{ ��>z�` y�:���i yZs <sz -3�z <br /> ' TENANT NAMt / "-- ' I�Z �i• <br /> i CONTAC7 FqR PERMI7 PMONC ��— <br /> `/1-r- {�' <br /> ��l., 7`� G��l«/� � � <br /> - E•MAIL <br /> CONiRaCtOR � � �� �-��—' - -AOORESS ` � " C Y/IT ZIP VHON� �' <br /> �v /�„�/%.� ,�j'R�s Y Jcc•��,� �< ��O / .�'�r.�,7�,�,c.. ���r�i` <br /> i corh�u5e.N,se a f'3'Zoj y 2j '" Z �'`l Z/6� <br /> ' - -�r��._LVSS �HZ �Y� <br /> . _ ,—. . _. . ._—. - <br /> USE OF 6UILDING -- HE'AT SOURCE I CONTRACT PR�CE OF WORK <br /> J �� �� <br /> �U h1 /1�1 C rL�a / — ..Elc•.cUic�Gas_ , Utnor ��j <br /> WORK DESCRIPT/IOfN / ,��� � �� � � �- — �— <br /> {' , �'�r�IGC �L�? � �uf �irr-/�< a < �� II <br /> I SQf�f�64y� <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYNE C1f FIXTUH[ OR IT[h7 NO. TYPE OF FI%TURE Of:I7EA1 <br /> _" �UilOI -- .. . .. /' �i��.-iMiL'aQ{4XrIMM1S _". _ ' <br /> 1 <br /> Hathitd? ._L ForceJ air 5ysienis I <br /> . I;.�-al0iy pv;�.^,h U2sin) G0�Vipinq <br /> _ ;;hmvcr Wa1Ef heutc�' � <br /> .__ 1<iiclien einh S dispo:;nl Gas tire��lace <br /> I)i;h�.V3Shur — G3ti fBOflO <br /> _ Clulhn�;NFlShei Gnthos dryer <br /> tiV:iter 1w:itnr R�nqo houd <br /> . . Sink (servicwharhnuplolc ) '— � . <br /> Gx idust tan <br /> _ bocknp�v pievcntrr ...— Iical Pump � <br /> i _ Unnal Unilhealr.r <br /> � __. D�mkm� Faunlain Ooilef <br /> � ., hlcnrdiain ` RefrigCfatiOn <br /> __ f.lieasr. lrnp — WooOSWvr. <br /> _ �i�uf dr;ims Other_. <br /> " <br /> _ QII;Bi — .. . ._ I <br /> _ ' _' .—_ <br /> I —. ... ..-.— '—' . _— '_— . __. .__.. __ I <br /> � CI7Y OI' Ev[RETT LOCA� SALES TA%CODE IS 71U5 <br /> I - _—' _— " " —_ <br /> I hr.rohy ceub�y lMl I huw: rna�.l anu��xaquned lhis a�i�ilication and aww the ssme tn be true nnA r,urn:ct. ql1 pwvisinns uf i�ws�nd <br /> ortlmnm5 r�uvernin,�ihis lypr.nl �vinh will hq tumplind with whr.lhoi 5pecificA herein or noL The grarding uf i pernel dor.s not presum0 � <br /> , in pivrz �ullwaty lo violata ur r.an,:el lho prpvisiun ui:my oihr.r at.d�a or lucal 12w r�yulatinp cunstructi0u ur Ihc pPdurrn;inci.c( � <br /> . r.nnctiudion. I hFlt I am aullioi i�.�il by thn Owner Jf ihiS prVperty Ip�,erform thC wurk(or whicli applicabun is made�nA i cuinpty wnh the <br /> SL:JIC C���lUfS L;1lV IQ.G! kC:b": �enJ 2S7fi.i0051�AC � <br /> r / ; <br /> � /`'/' � . 3-- r�_/O <br /> S'iyi�i«;ot 0��.�111!l���n.i����ulilqfi;f•�]/1yCN� DAte <br /> I <br /> —_" <br /> .. —. .._. '__ <br />