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.. r- - <br /> RMIT APPLIGATIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —wyw✓.everettwa.org <br /> A?PL�CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.k PERMIT# <br /> �9z0 2.���' �R S� 2 05/'TOD �/�200 -Ol 5 <br /> I.EGA LOT NO. BLOCK TRACT OR SUBDIVISION M <br /> DESC 3 1,2�2-�IZ D '7 _ <br /> OWNEP ADDRESS CITVlZIP PHONE <br /> ��c��� G�uNr,�Y GorvSr,�c��no Fa �X �3a� �.eVs� 9�27D 3G,�-9��- 7 <br /> I TENANT NAME � .�CO-NTACT FOR P�E "IT PHONE j'�Q��_��7 <br /> �JGSSiI'�� f//'.�'J�R.�tl e�na� ECCHOM����a+L »� <br /> �rvrz�� � <br /> ��C'�LE �o�r,vr.�y �O,�Sr �6 �DX 130�4 ° <br /> CONTR.�ICEN;:!# I�I�y 511�11� 3Lb-9_S9-.Si37 <br /> ��--��� ��9q� ,� � y <br /> USE OF BUILDING HEAT �JURCE CONTRACT PRICE OF WORK <br /> S�� _Eledric h Gas_Olher <br /> WORK DESCRIPTION '' <br /> A DoiT/ON�G ��/iylh/�� �" M�G'h � 1'�IZ. , 3�S1 G �I <br /> 3a��N1-{{�U T l�i r��� �3� <br /> PLUMBING MECHANICAL <br /> NO. NPE OF FIXTURE OR ITEM � NO. TVPE OF FIXTURE OR ITEM <br /> Toilet A1C-au handlmg unds <br /> Bathtub Forced a�r sy5tems <br /> _ Lavatory (wash basin) Gas pip�ng O <br /> Shower Water healer � <br /> t Kdchen sink 3 disposal Gas fireplace /}°A <br /> � D,shvrasher _ Gas range (���0 <br /> Clothes washer Clothes dryer <br /> Water heater � Range hood <br /> Sink(serv�v�'bar/mop�elc) Exhaust lan A'%��Q�� � , <br /> RackAow preventer _ Heat pump ��J+`. F p� J � <br /> - unnal __ umt heate -��� p 1� �A <br /> �_ Dnnking Founta�n _ Bo�ler ���/ � <br /> Floordrain _ Re(nqeration �� A <br /> Grease lrap _ Woods�ove ����1�y. <br /> Roo(drains _ Olher ���j'A./� <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAJf CODE IS 1105 <br /> I hereby cert�ty that I nave read and examined this apphcation and knov�Uie same to ue true and correct All provisions of laws ard <br /> ordmances goveming this type of work will be comphed with whether specified hemm or not The granting of a permit does not presume <br /> to g�ve authonry to violate or cancel the provision o(any other state or loral law regulaUng consWction or the performance of <br /> c trudion. That I am a�thorized by he owner o(lhis pruperty ro pertorm the work for which applicabon is matle and I ramply w�th Ihe <br /> State Contractors Law 1827 W d 296. 0 WAC. <br /> i i!/!�� .X/ /d <br /> i ure of Owner tract uthor�zed A t Date <br />