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07.'19,'900i 'I'lll' I:i:08 I�:1\ 4P:i�2:�i�&S)45 �00.':00'1 <br /> PERMIT APPLICATION <br /> CITY OF EVERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' <br /> 425-257-8810— FAY,4?5-257-8857 —�w,nr�.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROPd 8 AN TO 4 PM <br /> SITE ADDRESS PARCEL TNC I.D..t PERMIT# <br /> , �1 <br /> ;� �t.i� ..–.L,V��Ij.y__ 5\ _ CLI��- ��il��'l�(%� -�1.. � ���� ��. "I - (.-�� <br /> L[GA 1.0T NO. 6LOCK TRACT OR SU[iDIVISION p <br /> DESC. <br /> OWNGR ADDRESS CIN21P PHONE <br /> -�U,�`���C_��+.j t,I� lc.�/izr;j-:ifi '�1J'� C�:���'i'r_� �� LV:;�Yi� iv��5 :�"k;� .���_,S�� .s� r._� _ <br /> TENANTNAIdE I CONTACTFORPERNIT PHON[ � <br /> g )_`i':�'�1 'Sl� ]�F <br /> !�.�,�. Y�• .t �1C ;,,�., E.MAIL�MUv1C�oY(_ e-1., i"�1T ,1'•r, <br /> Rn k s rv� o <br /> i ,,:- "' <br /> ..y t' \\c`L. C{.1'�'i�`l�ttr.Sll�,1-' -�1��C� i'Z �Ct j ')'���� '�C'�1. .. �!✓ ' r�'�Q111��'I...i4i�� _ �.pl i �� �7'�: . •i,-��..� .. <br /> CONTR.LICENSE p � ', �� <br /> V��� � �%tC��� <br /> USE OF[3UILUING f1[AT SOURC[ CONTRACT PRICE OF WORK <br /> ,. I �',,���.i `\ � _EleGric _Gas_Other ,__ <br /> WORK DESCRIPTION . <br /> _�t � � <br /> .. A� � l. � ��:�>1��1 �-� l.l,l��Y:: � 1:� l.1 ( ��� �.i��. <br /> ,J <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURG OR ITEM NO. � TYPE OF FI%NRE OR ITEM � <br /> Toilel ' NC–air handiing units <br /> �alhtub Forcutl air eystcros <br /> Lnvalory(waah baslnl u Gas pip!ng <br /> Sliowcr VJaWr hoatcr <br /> Kitchen sink 8 disposal Gas firAplaco � . . <br /> _ Dishwashnr _ Gasrango <br /> Clothes washer ._ Clothes dryer � <br /> � VJator healor Ranc�o hood <br /> StnA(sorvlcoNadmop�otc.) Exhaust lan <br /> [�,c�now�ro�o�,t�r Heat pump <br /> Urinal Unil hoator - <br /> D�inking�ount�in Bollor <br /> Floor draln Refrigorallon <br /> ` Groaso tnp Woodslovo <br /> Roo(drains Othor <br /> Othor � � � � — � � <br /> CIN OF EVER[TT LOCAL SAL[5 Tlilf CODG IS 3105. . � � <br /> I hereby corilily Uial I have read and examinod 4i's apnlicalion:,nd 4:now the samo to te truo and wrreG. NI provlsions of laws:ntl� �� <br /> ordinaces povernin�this�ypo of work H�ill bo compiiod with whelher sPocified herdn or noL Tho grantiny ol a permit doos nol prosumo <br /> lo glvo authority lo vjolalo of cancel.tho provislon of anY othcr slato or IoBal law regulating.wnsiruction of tho pedortnance�o( "���'.�� � <br /> cons�r4ctioi .Thal I am authorir.ed by iho owner of thls property lo perfonn tho�vork for which applica6on�s made and I comply Kith tlio �- <br /> Sta;q�ontr t rs Law 78.27 RCl'J and 2�6.200�,VAG. +, <br /> � ;�j��, i�;�,+��,: �� �//� <br /> Si�nati,ro of OwnodContractor/!�u ionzc�d Agenl OatO ��� <br /> � <br />