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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-887 0-FAX 425-257-8857-www.everettwa.org <br /> ��d� APpLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��- ����� <br /> SRE ADDRESS �VP.veN ,� R�'Z�j PARCEL TA7(I.D.• PERMR• <br /> ' SI,�kSG�, w � 01oo3� zzoo .�g� 0- cX�`�� <br /> LEGA LOT NO. BLOCK TIiACT OR SUBDIVIS10N+1 <br /> DESC. <br /> OWNER ADDRESS CITYfLIPQ�U PIIONE <br /> lG� (1.«l� 1�90� Va, l�4��.., 0� T•�;h.CA R`19-�iY� -`t`��l <br /> � <br /> 7ENANT NMAE CONTACT FOR PERMR P�E L�Xi-3Z,�I��U�(J <br /> Evevet-F C�n..ti.,�:�. Ccr�+- '�'p�l K�w t-{���-- E-MAIL Todd CI�{vintili5��� ''+ <br /> �v�� Si`��. Ccw.pc,. �oS7z �`cu_v S! . Sf�1�ie � � 2 3� i <br /> �o�.�E�. '1 �"' � z�c�--3 ��_ �. <br /> 4-0 l�-, S� c>� 8 r Z. �'1�(��� <br /> USE QF B ILD�NG HEAT SOURCE ONTRACT PRICE OF WORK <br /> F ue.•�ztt' `�'`�` �•, <br /> C�}y��,;� C�.�� _Electric _Gas_Olhcr �-L� <br /> WORK DESCRIP]lON .� .(�.– .4.���c�„-1- ��S�i�� n�' lw W�w�� CqtM�u�ii.�Qtt�-�' <br /> �n5�•.11 �J D�S 41u��� � +`�ov.�n+:.� <br /> ��i:UL. – ( ��V 11.���... �.� r PI���!'.�1-'C 1'.o('.J�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF f7)CTURE OR ITEM NO. TVPE OF FIICTURE Ofl ITEM <br /> Toi�el FUC–air handling uoits <br /> Bathtub Forced air systems <br /> �.avatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer _ Clothes dryer <br /> Water hea�er Range hood <br /> Sink(sarvice/badmop/etc.) _ Exhaust fan <br /> BackBo�v preventer ___ Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Ref rigeration <br /> Greaso trap _ Woodsrove <br /> Roof drains _ Other <br /> — aner _ <br /> CITY OF EVEflETT LOCAL SI1LE5 TAl(CODE IS 3105 <br /> I hereby ceritity�hal I have read and ezamined ihis applicatioa and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this typo of work will be complict�v.ith whether specitied horein or noL The grenting of a permit does not presume <br /> to give autho�ity to violate or cancel tha provision ot any other state or locai law regulating construction or the pedormance of <br /> constructic'� "iai,I authorized by the owner ol this property to pedorm the vrork lor which application is made and I comply with the <br /> State Oqona nr �8.27 RCW and 296.200 WAC. <br /> � V/ �� /�� <br /> Signatu cl ntracbdAuthonzed �t.mt-- ete �� <br /> Z <br />