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� - -- <br />�rERMiT APPLICATiJN <br />CITY OF EVERETT PERMIT SERVICES <br />37_00 CEDAR STR[L=T, EVCRETT, WA 9II201 <br />425-257-89I0 - FAX 425-257-fi857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / <br />---- _ �l� u 7'�3 5 <br />- - - --- <br />SITE ADDRf-SS PqRCEL TAX I.D. k PLI�,%��IT ft� <br />�,��L- '.,)...5 .r���a �ie �J���'n v�52.11or,LOoC�. =r1 _ I (.� 0��=��� <br />LEGAL LOl N0. ULOCN TRACT _. ------- �-- <br />u�_:;r.. -- �- � - <br />—�- --- � <br />OWNGH AUO CSS�, UyI --� CITV/ZIP � �1'IIGNI: <br />�'.c\clu-. `.�J��.'.. Z;w1Cil �.�.1.. �. J '.�" <br />------`-----t i Ih ��� 7a Il.tc• j�=. ili�-it���_c �tl <<q�i7� <br />TENANT NAMf -- --• --- <br />CONTACT FOR P[RMIT PIIONI: <br />-- � � L�.s•�t..:..1 i?-� -i43•-IZI� <br />CONTRAC70R _ __ - .-____-. �--- _ _—_ __ .. _ . __._ -___ _--___ .. <br />ADbRESS � CI7Y/71P PIIONL <br />1'��)(-�-�-1:L1,��37-c_i ���3'1--? 1 �� <br />CONTR.LIC[NSIFff � �li�'��- ��c..`,'��..`��-\"?. �{?,5..';•i ) <br />IZ1=j <br />US[ OF f3UILDING II H[AT SOURC[ CONI-RAC7 PRICI. OF WORK <br />�.,`.:� �.,\.����< -\«.w,-�.l-v�a.t��,..�k- - _ <br />_- -_ - - - -_--- -I ._. __ I'Icclr�r.—�-'t;:�s O�her I "�i �Ju, oc•U <br />WORf<�ESCIiIPIION -- -------��--�-. .. , <br />PLUMBING <br />No _ in�e or rix,ur.i_ oiz rrrn� <br />' iu�i�;i <br />i H:ilhlub <br />� 1 I_;rvnlory (�v:isli h;t;in) <br />�_ Shnwoi <br />� Kilchcn �;inlc R i6�;��ns.d <br />I Uishtv.�slu�r <br />t Clulhns �v;c:hcr <br />_�% N'nlui henli�i <br />__ ;:in6(;cieicr/I�.u/inn�,/o(r..) <br />Il:u'V.IIaIV pirvrnirr <br />_ Unnnl <br />__ I�iinkini�Fiiunlnin <br />Ilnu� dinin <br />— � Grc:r.;i� hnp <br />ROnI th,tim: <br />-- Ulhri <br />i✓ .:3u.G. %]:i?j <br />MECHANICAL <br />t+o. I ivr� or rixivar_ ot� neM <br />, NG --.tu h:IndOnr� iuliL•; <br />I Forcr.d air syslem:: <br />�l � Gas piping <br />I Wntcn c�;dm <br />_I_ Gnslu�r.pl;ir.c <br />--.1_ Gas ian�c <br />_L Clolhcs dryr.r <br />I Ranr�n hnorl / �r�, �, • R . <br />�{ [xhnuslinn <br />_.. I la.�l pump <br />Unil hcalnr <br />-- Bailcr <br />__ Refrigern�ion <br />Wood:;lovv <br />-- Olhcr <br />CI i Y OP EV[RETf LOCAL SALES TAX COOE IS 7105 <br />I hcrr.by r.cvlily Ih.d I hnvu �o:id �ind ux:vnined Ihis nppGr.;iiion and Y.nu�v thr, samc la bc huo anJ corrocl. All prnvisionr; ol laws mid <br />artiin:¢es �lnvi•inin{) Ihis IVP�' ��I �vor6 ���ill hn CompliCd wilh whUlhcr spCcilicd hGoin or nuL Thc yrmlinq ol a punnil dur,s nol pmsumr, <br />lo pive nidhunly lu �iulnle ui c;incel ihe piqvision ol any olher staln or Inc:il law rr.yttlalin� conshuclion oi ihu pi �ilunnance ol <br />r.nnsliucUrni. �I h:il I nm ;ailharized hy �hr o�vner of Ihis properly lo perform �he woik Inr which appticnlion is m:�dn nnd � r.omply �vilh 1he <br />;laln CaNuii:lnie I nw 171.:'7 RCVV :md �9fi100 WAC. <br />. � , ��/ <br />'- �'� =�="-�-�-'- -' _.—lJ.] I i1 ',: <br />Signalu�ci-�(�udConhor.lndniitharized��enl D,��e <br />