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� - <br /> PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S'fREET, EVERETT,WA 98201 <br /> 425-257-8810—FAX 425-257-8857—vwvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� ,��b�O7 <br /> SITE ADDRESS PARCEL TAX I.D.N P RMR! <br /> �>2 ' L l GY'C-2 ?- p 7�' -�� <br /> LEGA LOT NO. BLOCK TRAC70R SUBDIVISION• <br /> DESC. �J�'N�I� C��J IJ'UC� iT. �f`6T'C I�/EUV /fL-77 <br /> OWNER ADDRESS GTV21P PMONE <br /> C�•>�Y��vcN G3�c G(iG�� .1.�¢n�r,: ,v,E ��ir��8��✓t-�✓cC� zr 7 <br /> 7ENpH7� I COHTACTFORPER�IfT PMONE <br /> �/w�� E#IML <br /> �Y GWMI�7Z <br /> CONTfl.IICENSE R <br /> USE OF BUILDING HEAT SOURCE CONTRACT PPoCE OF WORK <br /> J�'� _Electiic _Gas�Other�/L <br /> WORK DESCRIPTION <br /> /tif��7��177tNVI� I�Cf� /t��l77GsV iZ� P//�?F�CC/'� JWl� {l.f1Qb!%��7'�}-� <br /> q= �ttr �r��L�r�- /n�r� rw r�C�x�Y ��u�uy,v� �;� ;<< � _.., - <br /> rr� -�� �,,.-�,� ;���:r', <br /> PLUM6ING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF FlXTURE OR REM <br /> ' Toilet A/C—air handling unils <br /> Batntub Forced air sy^'ems <br /> J Lavatory(wash basin) _ Gas piping <br /> � Shower Water heater <br /> — Kitchen sink 8 disposal _ Gas fiieplace <br /> v.L Dishwasher Gasrangu <br /> 2 Clothes washer �, Clolhes dryer <br /> � Wa�cn c�atcr _J Rangc hood <br /> �_ Sink(service/barlmopletc.) ,3� Exhausl fan <br /> �ackflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Founiain Boiler <br /> Floor drain Rclrigoration <br /> Grease trap Woodstove <br /> Root drains Other <br /> � _ Other _ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cenlity that I have read and examined this application and know the same to bo true and correct. AII provisions of laws and <br /> ordinaces goveming Ihis type of woik will be complied with whether specitied here�n or nol.The granling ol a permit does no�presu�ne <br /> , to give authonty lo violate or cancel the pmvision ol any olher stale or local law regulating consWction or t!�e pedormance of <br /> i constr�ction.That 1 am aulhorized by the owner ol ihis property to pedorm the work tor which applicati:n is made and I comply with the <br /> I State ontr to aw 1�27 FCW anA 29G200 WAC. <br /> � I S-n � <br /> Si Wre o (MmeACbnir� odAmhorized Agen� Dale <br /> /Z <br />