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�,,,.. _ _ k *''�^xr�U . ?r'M �yy�"� .. „ :��, � ( ., . ` ._. i„ .�;n. � �. �t � s} � <br /> 4 �'cCv s� � ..tE w .n,�� � ,`.i`, ..s: a^t �i'i F^=a.�k a3 = r <br />'` .��: �„'t `'f'N �r', �!t'R' � �y, . h7�x., t,c <br /> "" — M +X:i�.4 .�.N'� � � , s� .�� A*+tl•� "�1,� �, . i . <br /> _ _ — `i . . .. _ � -- - <br /> � PERMIT 4PPLiCATION <br /> CITY C1F EVERETT PERMIT SERVICES <br /> 3200 CFDAR STREET, EVERETT,WA 98201 � <br /> 425-257-88'S 0— FAX 425-257-8857—www.everettwa.org <br /> � <br /> APPLICATIONS ARE ACCEPTED FROM&AM TO 4 PM � <br /> 1 <br /> SITE ADDRESS PARCEL T.al(�.D.# PERMIT d � <br /> �� .z'I i� S� C✓� � .�- ' l� S� C G-�C�> ' ��1 , <br /> LEGA LOTNO. BLOCK TRACT <br /> DE` <br /> JWNER ADDRESS CITYILP PHONE <br /> ,. � �� ,� WiN i E� 8a3 37t�� S�- r�er�( % �S-,�SZ- 3z J <br /> . r- . , _�_ _ <br /> TENANT NAME� �r (1,6( � � CONTACT F PERMIT _ PHONE <br /> - �-1z - F-���1���, � S��� (.i�F�o 3�(��1-�3C� <br /> CONTR4CTOR . A�D ess �n�t cinrzia !�� HONE I 7 7�� <br /> ��`�w13��,S � ' � r�� �3 � <br /> c�,�-IJCENSEN ' � I�,g � 3221 C312 ti�l. RD ivC-LEY �A, <br /> US. , <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> W� /,�I/ % , _Electric _Gas_Other �/ Q Q s'� v <br /> � • � C l. 1/ C <br /> WORN DESCRIPTION U � <br /> `S EE ATf"AGH��' ��)rt !� S��3-�_ <br /> PLUMBING MECHANICAL I i <br /> NO. TYPE OF FIXTURE UR ITEM NO. TYPE UF FIXTURE OR ITEM � I <br /> Toilet _ A/C—airhandlingunits <br /> Bathlub _ Forcedairsystems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower _ Water heater <br /> Kitchen sink 8 disposal _ Gas fireplace <br /> Dishwasher _ Gas range <br /> Clolhes washer _ Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/harlmop/etc.) _ _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Unnal _ Unit heater <br /> _ Onnking Fountain _ Boiler <br /> Fluor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains — �hef <br /> other — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> t hereby ceritity thal I have read and examined thi:application and know the same to be true and cortect. AJ provisions of laws and <br /> ordinaces goveming lhis type of work will be compGcd wilh whether specifed herein or noL The granting of a pertnil does not presume � <br /> to give authorny to violale or cancel the provision ot any other state or;acai law regulating construdion or Ihe peKormance of <br /> construction.That I am aulhorized hy lhe owner of this property to peAortn the work for which applicetion is m.de and I comply wilh the <br /> Slate Conlractors Law 18. RCW and 2962001NAC. <br /> 8 g (� <br /> Signature of Owner/ ontre Auth�ized AgeN te <br /> � <br /> L--- / <br /> � "l �% � <br /> �-i�.; <br />