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PERMIT APPLICA710N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER6IT, WA 98201 <br />a25•25�-8810 — FAX 425•259-8857 — www.everotiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 0�1 TO 4 PM �" S <br />SRE ADGRESS PARCEL 7AX I.D. t <br />�o�u 33�d �� �/ I COs�i'1 Do30 (I.DI <br />ionn� �nrNO. BLOCK r TRACTOR9UBDMSION� <br />UESC. <br />owNER ADqRESS <br />5010 r�rq 14Ve V�. <br />I�V10.V�(�tf,t l�i5h►Mah _ <br />7ENANT NAME CONTACT FOR PER <br />WIQVGIw�— Q;SVIv✓la�,�✓1 I �� <br />USE OP BUILDING <br />� 1��� <br />WORK DE9CRIPTION <br />N0, I 7YrE OF FIX7URE oH ITEM <br />Toilgt <br />^ Betht�b <br />` I,avatory (wa.h basin) <br />J Shpwer <br />Kitchon sink 8 disposal <br />Dishwasher <br />� Clothes washer <br />N/A1Bf hB3l0f <br />Sink (service/barlmop�atc.) <br />^ 8ackflow pravantor <br />Urinal <br />-- Drinkinp Fountnin <br />Floor drain <br />� �roase trap <br />Roof dr�ins <br />_ Othor`� <br />p� SY►v�lavl <br />���..��_ <br />y co � o t'tic.►���'c.� n <br />w�-`� #e <br />HEATSOURCE <br />_Eioctdc 3Gas„Olner <br />� <br />PEpMIT p �r <br />nn r.CnS7 �f�rl`'� <br />u2s 355 N�z <br />�-1'LS 355 �D"�2 <br />�G+�t'C N� 35s y o� z <br />�iB203 <br />CONTRACT PRICE Op WORK <br />t�,t►5.qu <br />7YPE OF FUCTUflE OR ITEM <br />AIC — air handling units <br />Forced alr systems <br />Gas pipinA <br />Water heater <br />Gas nreplace <br />Ges ranpo <br />Clothas dryer <br />RangB hood <br />EzheU6Na� <br />Heal pump <br />Unit heater <br />BAiler <br />Fiefriggra60n <br />Woafstove <br />Othor <br />CI7Y pF EVERE'R LOCAI SAIES TAII CODfl 19 9708 <br />I heteby coriliry that I hpve read an0 exumined Ihis application arxf knuw tha sama to Oe truo and correcL All provisions of laws and <br />ordlnpces governing Ihis lype o1 woAc will be complied with whothor �pociliod horoin or noG Tho granting oi a permit does rrot presume <br />to givu aulhority to vi0iaro or cancel tho p!ovision of any othor state or local law rogulatinp eonstruc+icn or the per(ormance o� <br />eonsirucGon. That I a�1.aW�+ by t er of this p�oporty lo pedorm the work for which epplicatiatt i5 mad9 80d I COrtlply With MO <br />Slate Cy►�tran � Law� 7 R W� 296. D W AC. �'r. D� <br />�� J <br />2.Z'd LSBtlLSZ526T�01 �WOLd 0b��� o00Z-92-?JtiW <br />