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; <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> 3 I U�- �Y�• ���—� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PER T N <br /> r., ;-, ,�.�,�;�;i�ih.%=. G'C''13�/l' �'f3 Ol'! 02 �< Oi - c�d� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION 7i <br /> DESC. %! �/1rC/ �� ��� <br /> OWNER ADDRESS CITY2IP PHONE <br /> �f9ir� �i��'i�ri�' i/'u� 7�i�r'�Pc�i. �L'.�iUlr� 1f�'2�5' �s�5.3y�,X� 3 <br /> TENANT NAME ��(L ��1�� CO TACT FOR PERM�/IT PHONE �/,n . ���C��37 T� <br /> /� . ,�1 � - .'G��!/�CC//L�" GG' <br /> .�t 'll� ,� _ E-MAIL f� �� �j • • � � . <br /> ��(.�L��/7�C/VS/�'�lC�L� D �'.2C CflC�S/N� ��C�l:/7r�l^�G'% un <br /> S- 2�cJ`yl�� <br /> CONTR.LICENSE A ��I��� ��� �?,f�LC <br /> �-/k/ <br /> USE OF BUILDING HEAT SOURCE CO TRACT PR�CE OF WORK <br /> I� ��,� <br /> !�,9��/-��;'�T si� —����<<�� ✓ Gas_Olher l�y,�-�, <br /> woRKoescRiPnoH ,�/�.,�U• i/Vi/�'�G'/T i��HGGr�: GZ°C'� ��C�V�i�7'�l('%<C�/✓ <br /> !�'it iil/ /l�e"l2' �".h-r7�'fT/L�'i� /,7�'c�It°5 lti'iTl� /�'E7✓ ./?iC/�i7`E�X� <br /> ��, <br /> �%In�%l . . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet A/C-air handling units <br /> Balh�ub Forced air systems <br /> Lavatory(wash basin) �_ G2s pipiny <br /> Shower Waler healer <br /> Kilchen sink 8 disposal _ Gas fireplace <br /> Dishwaslier Gas range <br /> Clolhes washer Clothes dryer <br /> Waler heater Ranc��hood <br /> Sink(serviceNar/mop/etc.) _ Exhaust fan <br /> Backflow preventer _ Heal pump <br /> Urinal Unil healer <br /> Drinking Fountain . _ Boiler <br /> Floor drain Refrigeralion <br /> Grease trap _ Woodstove <br /> Roof drains Otner <br /> Olher � <br /> — — I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cerilify Ihat I have read and examined this application and know Ihe same to be We and wrrect. All provisions of laws and <br /> urdinacas governing lhis type o(work�vill be complied with whelher specified herein or not.The granling of a permit does nol presumc; <br /> lo grve authority to violate or cancel lhe provision of any oth��� ��aL,or local law regulating construction or the performance of <br /> construrfi.n P.�at I am authorized by Ihe owner ot lhis prop����� .o perform the•Nork for�vhich application Is made and I comply wilh lhe <br /> Stal.;�onlrac�or5 La�v 18.27 RCW and 296200 WAC. <br /> --"'; r, ��+� /^�% ?� L'L'� <br /> OI,_ , <br /> Siy a re o(�oNract- o~ dAulliori�zed Agent Dale <br /> � i�� <br />