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�25-252-74G6 fMNEATING Oe5a.58am oG-t3-lola <br />_ .. .. . • . . • <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-BB10 – FAX 425-Z57-8B57 – www.averettwa.org <br />SITE ADOflESS <br />L`�M1 LOT NO. <br />DESC. <br />OWNER <br />�` <br />7ENHNTNAME <br />In� <br />USE OF BUILDING <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM G� � 3� � C� <br />��n�11 PARCELTAXI.O.p P/yE^RMI 0 _O� <br />b /YI <br />OLOCK TAACT OR SUBDIVISION p <br />� �yUY�IC/ LI.S �.�JVY� ""J <br />I CONTACT FOfl PEHMIT <br />l�ie <br />�4�5 Br uXu.� E�ex�e# 98Zoi� <br />� <br />I HEATSOURCE <br />V Electrlc _Gas_Olher <br />WORK OESCRIPTION <br />� VIS� � � � �`�'�.�c.s s�Ov"�' �� <br />NO. � TYAE OF Fl%TURE Ofi REM <br />Toilct <br />Balhluh <br />Lavatory (wash basin) <br />Showet <br />Kltchan slnk 8 dl;posal <br />Olshwashor <br />Clolhns washor <br />Walcr hoatcr <br />Slnk (servlcclbar/mop/atc.) <br />Backllow pravenlar <br />Urinol <br />DHnking Fountaln <br />FIOOr draln <br />G�aaso trap <br />— -Aool3ralns <br />Othor <br />�12525q��6� <br />5��5!OD WORK <br />NO. I TYPE OF FIl(TURE OP ITEM <br />A/C — alr handllnp units <br />Forcod air nyslems <br />Gas plping <br />Walar heater <br />Gas tireplaco <br />Gas ranpo <br />Clolhos drycr <br />fianpalmotl <br />Exhauslion <br />Ncal pump <br />Unll hoatcr <br />Boiler <br />Relrigeratlon <br />lNoad6lovc <br />Other <br />CRY OF EVEREff LOCAL SALES TAX COOE IS 9705 <br />1 heroby centity Ihal I havo read and oxaminad fhie appllcnllon en0 Nnow Ihe eama to be Iruo nnd corteci. All provlslons oi laws and <br />ordinaces governing Ihls lype of work wlll be ccmplled wlth whelhor spectlled horeln or noL Tho granting ol a pertnll does not presume <br />to p(ve aulhorlly to vlolate or cancel Ihe provlslon of any othor slato or local law regutating conslrucllon or tho perlormance ol <br />conslrucllon. Thal 1 am au�liorizad by Ihe owner ol Ihls property lo peAartn !he work for which appllcatlan Is made and I compiy with Ihe <br />State Contraclors Law 18.27 RCW and 296.200 WAC. <br />I�,hbii I��,a�� �fn�l 3 �l�_ . <br />2;M1 <br />