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`��'YHz..Ss..:. . <br />.;\^ <br /> ���'�' �� --- -- <br /> i3."�i' <br /> � PEr2MiT �PI'LICA�fION <br /> CITY OF EVERETT PERMIT SERVICES <br /> �" 3200 CEDAR STREET, EVERETT, W,�9Ei201 <br /> 425-257-8810 — FAX 425-257-8857 —v,v✓w.everettwa.org <br /> �ri. <br />',S<Frh. <br />,,�, r�, APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� �J1N, <br />.�'�� SITE ADDRESS LL�� � 3G� �% � PARCEL TAX I.D.# pERM1T# ' <br />,� o z _ Y�0 jj�-�-O,jg <br /> r���uLT�- �az�� ! <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CIl`.hiF PHONE � <br /> ��7�.�J�:tS t-�un+`SQlz2�,�--fr� Zttc�7 3�1`1ti .�� kzs zs9 — i <br /> �zv/ i:v2Co <br /> �fENANTNAME I CONTACTFOF.PERMIT PHONE <br /> �!�/-lil.�� <br /> CONTRACTOR ADDRESS CITYiZIP PHONE <br /> e��/�,f�'jZ <br /> CONTR. LICENSE# <br /> USE OF BUILDING HEAT ': �URCE CONTRACT PRICE OF WORK <br /> C�m ri ) Ij��-��-- <br /> r���3 Z�,y/���v� __Eleclric �Gas_Other I ,� �p (��� <br /> J <br /> WORK DESCRIPTION <br /> /�-� '!�'.� G;r� 5 5�-�- l�`1'�--�� � � 1'��'-� l�-�i�z(z-S <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet A/C—airhandlingunils <br /> _ Dathtub Forced air syslem� <br /> _ Lavatory(wash basin) �� Gas pipiny � <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange <br /> _ Clolhes washer Clothes dryer <br /> _ Water heater Range hood <br />�� _ Sink(service/badmop/etcJ Exhaust fan <br /> _ BackOow prevenler Heal pump <br /> _ Urinal � Unit healer <br /> Drinking Fountain 8oiler <br /> Floor drain Refrigeralion <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other — <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby ceriti(y that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and <br /> ordinaces goveming this typo of work will 6e complied wilh whelher specified herein or not.The granlin�of a permit does nol presmne <br /> to give authorily to violate or cancel lhe provision of any other state or local law regulaling consWction or the per(ormance o( <br /> conslruction.That�am aulhorized by lhe owner of lhis property to perform lhe work for which applicalion is made and I comply with lhe <br /> Slate Contrac�tors Law 1�.27 RCW and 96.200 WAC. <br /> `{-���� �. V���� ��W�� � Z— 20'-O � <br /> Signalure of OwnedConlraclor Authonzed Agent Date <br /> _� <br /> � <br />