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May- 16- 11 11 : 28A , � P .O1 <br /> ..- - ------/ . —.._ _ „� <br /> \ <br /> PERMIT APPLICATION <br /> CITY OF EVI:RETT PERMIT S�RVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 -• FAX A25-25 T-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br /> SITE AD�RESS PARCEL TAJ(I.D.# PERMIT p <br /> i y�,,� z 3 "�"�U� _ _�.�� f�� ����,.- ����� <br /> LFGnI� LOTNO. uWCK TRACTORSUBDIVISIONM <br /> uE:;c:.� I_._- <br /> OWNER ADDRE£5 —� \ CITYlZIP PH�7NE <br /> -Y�' f > , ��?y-35 j - �z i <br /> ���ni? �rs�-u'r� ., c:�..i_,_ �/��G � 3 :�•r /.0 ,�i'u�� ��1's _ _ _..-- <br /> IENANTNhME CONTACTF012PEftM1T PHONE � 3�,� 7 z E' <br /> . Lfi.l__' �.. <br /> ��� �.1./., �1-r�.6.� �-��� <br /> � CON7RACTOR �� �����-� � �� AD�RESS CITYIZIP PHORE�� <br /> �y�9�j.c/rr- %�;i r', `/ .,Sr.-v�L� j,�L'/ �t!<i i!-�'�''C �v'.v� %f�1°'/ <br /> CONTH.UCENSE p <br /> -- --� ��`;�-��s_c��/2.�rz ��ZS 1.s,_ •z_/G <br /> USE OF/BUILD�NG - - HEl1T SOURGE I CONTRACT PRICE OF WORK <br /> /) �' S Electric �Gas_„__Other j l�fi'G� �` <br /> WORKDESCRIFTION �¢� y /�'y� �C ../-� G�r>Y+�` <br /> i�) �F �C�[ � r"cqlYlR�L. "� //�/ L!'Y/(i� �Y� / �' � <br /> �i!' C G � Jtl�)l Ct'i �/ ���Os�� �� s7`Z.-i'[ �oCi'ri� <br /> IPLUMBING � MECHANICAL <br /> � NO. TYPE Of FIXTURE OR tieM NO. TYPE OF FIX7URE OR ITEM <br /> _ ---• -._..-_.. . ... _...._ _ --. ..— <br /> _ T��ilel A/C-airhandlingunils <br /> f�athtu7 Z Forced air system:. <br /> _ I.iv�lory(wdsli L2siii) Gas plping <br /> � Showr.r � Walef heat�r <br /> __ I<ilr.hr.n sink tl,disp �s:il Gas fireplace <br /> Uishwn5h�r G89f00ge <br /> Clulhes wa�;hcr Clothes dryer � <br /> W ater heatcr Ranpe hood <br /> 51nk(savice/b2r/nlU�delr ) Exhaust fan <br /> 8ack(luw preventm' Heat pump <br /> Ui in0l Unit heater <br /> � Urinkinp �Uwdain 8oiler <br /> fioordreir. � Refrigeralion <br /> _ . Gre�sr. trap WoodsWve <br /> � Roo(drains I - Olher <br /> Olhr.r <br /> ^CITY OF EVBqETT LOCAL SALES TnX CODE IS 3105 <br /> I IiercUy r.crility th�t I h2ve read anrf nxamined q�is applicatirni and Icnow Ihe same lo be true and corrocl, All provis.ns ot laws�nd <br /> uidmaces yovarnin�Ihis lyVe uf wurk will bo coinplied wilh whother specified herein o�not.The pr�nting ot a petmil does not prp5wl�e <br /> ��?�IVY ���I�IIUfIIY�O VIOIAI�: OI 1;i�11GYI �hf: f1fOVI;inn of 2ny uther stalo o�Iocal law regulaling conslruction or tho porto�mance of <br /> r,onst�uclior�. 'I'hat I �im authuri�ed by l'ne nwnor ot this prc�perty to�ortorm Oie work for which applicalion is made 2nd I�.:umply wi�h Iho <br /> Slale Cuntr�r,lor.; Law Ifi.27 RC1N and Y9fi.?00 WAC. <br /> r. - <br /> ' � . f� �-"�s� <br /> :;i��n:aiive uf OwncrlConlrai;IOdAulhutized A�enl Dele <br /> .. —' -- �� -- � - --�' - . . _.. ._ .. ._�J <br />