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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 /> APPLICATIONS ARE ACCEPTEU FROM 6 AM TO 4 PM � Z � a Jn <br /> SITE AODRESS PARCEL TAX I.D.• RERMIT/ <br /> 1 � uii. _ _T` _C7;�� <br /> I.EGA LOT NO. BLOCK TRACT OR SUSDM510N N <br /> OESC. <br /> OWNER ADDRE83 CITY2IP P <br /> Mk. ,!r�.� /�.�,-�,.�, S,Re. �y G�r y ,C,� . �/9�L � 9�?n'' S�ri Cr� <br /> TENANT NAME I CONTACT FOR PE IT PNONE(/rZs+ �G�-GGC� <br /> �C7G1L L�/N / T.4,�l.�i'///� E�11AIL��� I- � yN� � <br /> o � I E�,,,�.,,.,to <br /> CONTR.LICENSE f{ <br /> USE OF BUILDING I ` HEAT SOURCE I CONTRACT PRICE OF WORK <br /> � S�% I --- Electric J{Gas--- Olher �(�� y�v <br /> . � <br /> WORK DESCRIPTION � / / � / ?OV /y �QdGY <br /> %r�v.F�+�r- i�cr�r'ovBtr�2Ytl" 7�O /�/ Ndt /, y�. +t'. �a� <br /> � u� s�z �. N�u.,/fi.n.�� coF�� �c '�; lz� uN:r,ek .�oA <br /> �a.'/e� rcr�cysf <br /> �F PLUMBING �- MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FU(TURE OR ITEM <br /> � Toilet __ A/C-air handling unils <br /> Bathtub Forced air systems <br /> _� Lavalory(wash basin) �`p���l f �µ�� ____ Gas pipin{� <br /> / �,,�/�� Water t�eater <br /> Shower � � <br /> i =--= Kilchen sink 8 disposal � 4C o�//^Pw� 7�oi� --= Gas fireplace ���_ LJ6t,�.� I <br /> Dishwaslier Gas range �� � <br /> __ __ Clothes washer S�'j'�'��y ____ Clothes dryer � � �'E��'� <br /> ____ Water heater Range huod -�ir�y <br /> ____ Sink(service/baUmop/etc.) __ E�chausl fan ( <br /> ____ Back(low prevenler Heat pump <br /> ____ Urinal Unitheater <br /> ___ Drinking Fountain Boiler <br /> ____ Floordrain __ Refngeralion <br /> _____ Grease Irap __ Woodstove <br /> _,___ Roof drains __ Olher_______ <br /> --- Other--------- -- <br /> I CITY OF EVERETT LOCM.SALES 7A%CODE IS 3105 <br /> I hereby certify that 1 have read and ezamined this application and know the same ro be true and cortect. All provisions ot laws and <br /> ordinances governing ihis type of work will be complied with whether spxifed herein or not.The granUng of a pertnit does not presume <br /> lo give authority lo violate or cancel the provision of any other state rir local law regulafing construclion or the peAortnarroe o( <br /> cor.slruction. That I am authorized by the owner of this property to pedortn Ihe work for which applicaGon is made and I oomply with the <br /> Slate Contractors Law 1827 RCW and 296.200 WAC. <br /> iSteve M. Gwinn �u:;;�,;:::=:°M.,::-:_R i��� ;��/� �� ( <br /> Signalu�e of OwnedConlrac�odA�ihonzed.Agent � pate � <br />