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� <br /> Dec-Ot3- 10 09 : 22A p . 02 <br /> __. _ _____ _______., ._._'____. .'. ._ - . . ._—'__.__— � <br /> i F'cRMiT APPLICATION <br /> CITY' O�F EVERETT pERMlT SERVICES � <br /> 32U0 CEDAR S7REET, EVERETT, WA 982U1 <br /> � 4?.5-257-8810 -- FAX A25-257-8857— www.everettwa.org <br /> APPLICATIONS �RE ACCEPTED FROM 8 AM TO 4 Phi <br /> _...._— . _ . _— I <br /> SI7E ADDRE55 pARCEL TAX I.D. Y I PERMIT Y ' <br /> _�1..��� ��`:. sF � _. .. —_.L� � o i � ��3� <br /> __. _ <br /> �.CG�L, LOT NO, � Lu_OCK YRnC7 OR SUB�IYISION# <br /> II JLhC.I• <br /> OWNER ' ' .. ."—" AP�RESS --"�•.�CITY/ZIP PHONE '-'f . .- . . .— <br /> � �G�{ �or�r� � �/l �/ 77" .57`�3� �v°'��99zo 3 'i`zi- y 3-z -6'G/6 <br /> ! 7[NaNTNAME CONTACiFOIipERMiT PHONE I <br /> ; ��Cc'//s7`.;� '�z5-z,3a _/�z!' � <br /> E•h7AIL <br /> � CONTRACTOR ����� � �� < ��—�b6RE�5 y,f- CINlZIP� �PH NE � <br /> � ��//�j�/.— 5ry /rt� � ,/`'�� �,�c/ LG'���/ i�"'� 'I <br /> CUNN2. LICENSE k �. �Z�J�Z.sI �Z��I ' <br /> �Y�,c�s� o�>��Z �����y$Z�� _ _.._ ' <br /> USE OF BUILDIN� HEi�T SOURCE CONTRACf PRICE OF WORK <br /> i : <br /> n� <br /> P 5� ^ eit�U�� ,�U�5__o�no� �7 ��.v <br /> IWORK OESCRIPTION ---'�_.^•._R� — ' �'—._.. <br /> ��/�� �;s .�;,���� ,� <br /> PLUMeING � �� MECHANICAL � � I <br /> NO. TYPE UF FIXTURE OR ITEM NO. TYPE OF FIx7UFiE OR ITEM <br /> ��. Tnilnt WC-air liandlin�� unils ....-.— <br /> f�atlttub 1_ Forced air syslems i <br /> I __ L�ava�niy (wa,h bB;in) -- Ges pipiny i <br /> _,_ Sho�vcr lNale�heater � <br /> _, f(ilClien sinp.a di5p�iszJ _ Gas(ireplacn <br /> __ Dishv:�sher _ Gas rengu II <br /> _ Ciolhrs w;i;her Clolhe5 drycr <br /> _..__ �Vatcr hnatcr Ranpo hood � <br /> _. Sink (service/beduwprelc.) E%heuet fan <br /> _ Backfiow prevenler � � Heat pump <br /> __ Unnal Unil hoator <br /> piinkinJ Fnuntain Doiler <br /> _ finor�fr.�h� Roi�iporation I <br /> rrcas�>irap Woudstove i <br /> Ruol Urains Olher i <br /> IOther_ .�"— . <br /> — ------ — — � <br /> ----._ . . . .. . . . . . .._.. .---.._.... . . .. ..._.___._ ...-____.. ._. .. . - � ------`------' ; <br /> � CITY OF EVERETT LOCAI.SALES TAX CODE IS 3I05 <br /> II herr.by cr.rili(y ihal I hacte reaJ and examined lhis;applicaliun anJ know Ilie same lu be true and correc�. All pruvisiuns of iuws and <br /> ordinar.r.,�ovemin� lhis ty���:ol �•urh �vill bu complieJ wilh wheUiei speci(iud herein or noL The yr�nGn,y uf a perrnil daes nul presurne: <br /> to(pve aulhoriiy W vinlatr�nr r.�ncni thn pmvisi0n of:iny nthr.r st:itr;or Inc•.�il law rr.gulc�tiny cantilniction nr Ihr.pr.rfnrm.m�x ot <br /> conslructiun. That t am aulhnrizc:d by ihc ownr,r ot this proporty to perform thu worF:for which application is madc and I cumply�.vith Ihe ' <br /> I Slale Cunlr /toi�s I.aw .%7 RG\�V and 796.2p0 4VAC. I <br /> I �,�G�_ /2. �_c� '�� j <br /> Sq7n,du�e ul Utvneri!:urUaclur.0'lufhurited Apent p��p i <br /> --- - — --- ---.J <br />