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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 /> FPt'i.ICATION3 ARE ACCEPTEO FROM 8 AM TO 4 PM 6 -y�D � <br /> SITE ADDRESS 2� H C`''`�'i `�`�`" PARCEL TAX I.D.N PERMIT A <br /> S`^�c � �'O"yq'2,13 `/3 91 bY' �70 1 9 U 2 <br /> Fv A <br /> LEGAL 4OT NO BLOCK 7AACT O <br /> DESC. All lp'1'S' I� Z �K��� f�.A� <br /> R f/ � �' <br /> OWNER ADDRE35 �y � roP WA PM �1S-.ZSI-SdQO <br /> 2000 {�t�.+ll� �IAA rcVVt�'f� <br /> Evcic�} �ve�r}' �c,n�-,p/ SU.iTE '� � 9Y21? <br /> TENANT NAME CONTACT FOR PERMR � <br /> E�cra�'t- E�w�+ Ctr-hw I �o,,-� �o,plvw��'-c �o j 7b�-'SA9lo <br /> CONTRACTOR 1 - - ADDRESS �m�P PM� <br /> /1/�AC.�OV�0.�G� M.�U�'� �71"1 �e.�Nlt �W. SW S[.A��W/� ��� 7L�y�7 <br /> CONTR.UCENSE N��C�O F S "t�� �c.�J I Z'�3 �^�� <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> �pr�,yr.a,r��q.� I _Eledric �C Gas_OM�er � ��� �S) <br /> wo_�oscarurp�, �o,, l�oiL�.., .�►,s�l l � 149 Mf3F1 �oh �� ��,. <br /> �Q, S,�,a� .t-o..,x W 4S,ou�-{ g� P►p,rg <br /> �rs�� � � . ��c coMb A�.. ve.�F I, � <br /> N^,� nl4e.t�3'PTC C�.r4�r 1 naa,, C�'�t � <br /> PLUMBING MECHA I AL <br /> NO. TYP!OF FO(TURE OR ITEM NO. 7YPE OF flXTURE OR REM <br /> Toilet _ fVC-airhendlingunits <br /> Bathtub Forced air systems <br /> Lavato (wash basin) � Gas piping <br /> Showe� _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Ges renge <br /> Clothes washer _ CkMea dryer <br /> Laundry tray _ Range hood <br /> Sink(serviceibarlmopletc.) _ Exh�uscfan <br /> Backflow preventer _ Heet pump <br /> � Urinei Unit haeter <br /> _ Drinking Fountain '� Boiler <br /> Floor drain _ Re(rigarelion <br /> Grease trap _ W�dstove <br /> Roof drains _ Other <br /> Olher — <br /> CIT'OF EVERETT LOCAL SALE9 TAX CODE IS StOS <br /> I hereby ceritiy that I have read and examined this applicalion and knaw the sama[o be true and correcl. All provisions o(lews and <br /> ordinaces governing this type of work will be compiied with whether specified herein or not.The granting of a pertnit does not presume <br /> to give authority to violate or cancel the provision oi any other state or local law regulating construction or the perfortnence of <br /> construction.Th:.l I am authorized by the owner ot this property to pertortn the work for which epplication Is made and I comply with the <br /> Contractors Law 1027 and 296.200 WAC. <br /> ��� ��a� <br /> �S'ign wnedContractorl uthonze gent ate <br />