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i ( � <br /> PERMIT �':PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> d200 CFDAR STREE'I EVER[TT. WA 9820 i <br /> q7_9-15l-80 ip - fAX 425-2!ii-F�;5"r - www everetlw.� oru <br /> �J/7�/_ __ APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM _ _ <br /> 77 �f� <br /> SITE ADDRESS PARCEL TAX LO. N �. PERMIT fl <br /> - - �h � t? �_ _._ 22�0� 171�D31z-.�U ._C►a,,a - oi4 <br /> 'r��-5 S — <br /> i EG„i� i.oT r+o i oi.ocK TRACT OR SUBDIVISION�+ C�Ty U F EV�iZEIT�I�0�-U12-D�] <br /> �,�s_: ;- - � I -__ �-y�.�i- z�c�s�3� 3 5�.n.� <br /> OWNEfi �OORESS CIiV/71P PHONE <br /> � L�r��s�N -- 5�� -p�cvs_ ��v�2�1_T__,Lt� --- <br /> iFNANT NAME I CON7ACT POR PF.RMIT PHONE3GG-�-5�- -5!3 7 <br /> i.��SS ►CYa �-ND�'S0� E�MAILn7� ��ry��g�►I.�m <br /> �. CORTRACTOR � � � ADDRE$$�� CIiYIZIP� � <br /> ' �k��� CoLc�ur�y �yNs�r�u��bn PD �DX 150� MJF�-��►��u-c, �cc-�sg-si37 <br /> _��L��C942N � -- -- ---. ----- -W�? _Qkz��— - <br /> USE OF BUILDING HEAT SOURCE CONTRACT FRICE O("WORK <br /> s� �z, _�:i�rti� _�i<,,s_ i n,,:;� � 9--�T=^�TT <br /> I ------ _.__. 1 ----- <br /> --- -- ------ — . <br /> WORK DESCRIPTION ` ,f�}� � a�Y,� ��; / <br /> �1V✓•� `.s�� i 7 <br /> ' �.5�c 33�5 <br /> ; PLUMBING I MECHANICAL <br /> NO. I I YPF UF FI%TURE Oft 17fN1 .._ .__...-_ _-NO. iYFE OF FIX7URE OR ITEM <br /> __ ____—_.—_...____ _ _. _�_ . ____ --___. <br />. �j �i T��.I-1 _ _ NC - �u liancll�ny�.r:do- <br /> .. >� Gmhlub 1. . f urccd a�� sYslams <br /> .�_ I :roa�uiV::rishlrsc��� _3_ ;vaspiUin� <br /> �. . I 'iJelei ���ealC:i <br /> $ti�Yni� <br /> . I.� '� KqCheq S�qF d dI51�c5a1 .._I_ (.;d5 hrEpl2[i- <br /> I I Distiviashe, Gas ianp� <br /> . .�_! i:;otlu�r,auh;: i Clot'n,;sdiy_�i <br /> 1 'i�/a:ei heaea . � IZanye hood <br /> _`- jptk 15o'vc:C:he�•�nnpi:.:l I _� [-sI18Utit(il� � <br /> , u�i'.kU•n:pifi.�i;1-: I Itlel �>unt��, <br /> � Unca• ._ Unii IrEalei � <br /> _— [�nPkm)Ffvnldir __ HoJdr . <br /> Floo' :Irar,� _ Re6igcialinn <br />• _._"' C�3�Sc�fH�� 'idG0�gI0VF. <br /> R001 rJf8�q5 Jihe'_'__ '_'__ <br /> _— ' — <br /> l�l':e1 <br /> __._.� _ _' ._ ...."_'—_" "'___ ' _.__" . _ ' <br /> _ ._._.._.._ . _'—. __ . ___ -- . ' '— <br /> (:I7Y OF EVERET�f!UCAL SALES 7AX COOE�S 3f05 <br /> i L��mbVi certdy t���at i ha•i�ie�d .ind examined mis apulr.�ino�i a�.¢1 kno�:the�a�ne to Ue trua and r,oneri All p�cv�s�an,ol iav,s ann -- <br /> oidur,incrs uovernnel Uns Iy,,;nl w�:nk edill he cqmphed v:dh r:helhF� spe[:dieJ heiein et nol Tli�.ci+inlnii�ni n�'e•nni dCas not presiunr: <br /> t0 ywt au�hMity�a v�olalr.Or r.tin::el Ih�. ��uvisibn of any ulhci =!afe u� .acal la�v�eyula��ny r.nns!wr,ir.n ui Ine peilunr,anca of <br /> �.:o�i;Irur.Lon I-ha! I a�o aidliori-eci b� h�ovmei el!nis fro�:e�tY In pr•l^nn ihe ciork foi mh:�h acP'�,:at�.un is mnde an:l I cemp'y c�ith Ihr. <br /> . a nUacfoic i.aw iF;•..i F,':"f,���d 19F O(1:' C � <br /> /� � I <br /> _ /_ ������ ���G/D ' <br /> Su �al:i�irTSi' ontraclrn nu!�onzr,•rl A�ei Gate ! <br /> �- <br /> � ��Z ' <br />