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� �. i <br /> � PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � `aG _ �� <br /> � 3200 CEDAR STREE"f cVERETT. WA 9820I <br /> 425-257-8810 - PAX 425-257-8857 - www.evere+ a urg � � � i—C� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> --.__ -- <br /> -----_ ---- ___ <br /> SITE ADDRESS PARCEL TAX I.U.# � PERMIi q <br /> � 99oCv 25�' DR S� - _-_-_ -�0 51'1 �o� l 1200 _— I--�7-25__ <br /> _ _ - - _ .- <br /> � LEGAI LOT N0. OIOCK TRACT OR SUBUIVISION# � <br /> oesc � � I S�F�2T Pt1�T 1 ,2D2—D12-0'1 <br /> OWNER -�- —�.. ..-.-. �---� ADDRF�S �� �--.- .. . .. -CRV/ZIP PHONE -.._ . <br /> I I`1�NTl �Lf� C R�C-� __99DC� 25�=h D� S� �vE2ER �z5•22.�•SG55 <br /> � TENANT NAME CONTACT FOR PERMIT PHONE �(p�-4�-�'j�7j7 . <br /> CONTRA ' . � , I��SS1C�k �NDERSbN_ � __��ria �M <br /> ' � � CTbR ._ .. ..,�� .—. A�6R-�3`S-.. ___. . __. . - - CITVIZIP �MtI--PIiTNEM�S _ IL'(�, <br /> � ��C�LE CGCtNT�`� CONS,TRLICT��N �,, . . , , . . . <br /> � CONTR LICENSE -` '• � `- '' <br /> E�C�L� L�C9h 2 N � � PD 13b��"13C� '�" M�RyS�I l,l� �fn0--�54 5137 <br /> I USE OF BUILDING i HEAT SOURCE ^ 1/n CONTRACT PRICE OF WORK �, <br /> I�i tf � <br /> ' S 1�DP --L --_--F�r�.�:� _��,5_ ���h�, � � ODU -- - _ <br /> i V�ORN�ESCRIPTION �Y�A.�� L�TI �7 1_y 9�. S�-{'D� <br /> � r'� n i ,<.����<- <br /> I <br /> PIUMBING MECHANICAL <br /> NC. TVPE UF FI%TURE OR 17EM N0. TYPE OF FIKTURE OR ITEM <br /> � ____ ..__. _ __ ..—'__— <br /> Tciiel _ NC-air handluiy unds <br /> ' G�n,i��n __. ro�ced a�� 5ysia�„s � <br /> I � Lavalory(Lvash basinl = Gas pipiny <br /> —I Showe� `N�lei heatet <br /> � Knchen s�n9 3 disposal _ _ Gas fireplace <br /> Dishwashe� , _. Gas range I <br /> �� Clothes washei _ Clothes Aiyer <br /> -- N/a:e� heater Range hood ; . <br /> jirk (scrviccibaNmo�:l�:c 1 _ Exhaust fan i <br /> �ack0ow prevente: ..___ lieal pump <br /> I _ Unnal ._ Unil healer i <br /> , Grinking Fountain Boi�er <br /> � Floo� :Irain Refrigeralion <br /> ��. Grease Irap 'fJoodslove '. <br /> � ----� Real drams _ Other 'I <br /> I — Omer — <br /> i — _. - - — - ---- <br /> j -- -- ---- --- , <br /> CITY OF EVERETT LOCAI SALES TA%COOE IS 7105 _ _ _ _ <br /> I heraby ceAity thal i havE read and exarnined Inis apph�auon and knor the same to be true and correa All orm;isions of laws znd '', <br /> oidinances�oveaning Ihis lypa ol v+rnk will he comphed vidh�vhether specified herEin or not The grantm�ol a pennil Aoes nn�presume <br /> I lo yw�authonty to violale or cancel Ihe provisiun ot any uU�r� siate o� iocal iaw�eyulalmy conslrur.uen oi u�e periormance of � <br /> conslruc6on Thai 1 Bm BUIhO�ized by IhB O�vnBr ol lhi5 property to peAorm Ih=work for whir.h apphcaLon is made and I comp�y with lhe <br /> � State C nbactors Law IE 27 C'N and 296 20D 4VHf <br /> �-� 9• �• ZG/D <br /> %�'• ,i" , <br /> �I (c at ro of wne � ontractoriAuthorized Agenl Oale � <br /> �� �� � <br /> I _ - -- _ , <br />