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� - <br /> . ---�- _ <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEZETT,WA 98201 <br /> 42&257-8810-FAX 425-257-8657-www.everettwa.wg <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRE3S PARCEL 7A%I.D.# PERMIT# <br /> C%`I � y� ��C Gb`�rSSa0UOG2Cr0 �CGS - �._ <br /> LEGA LOTNO. BLOCK TRACT <br /> OESC. <br /> OWNER ADDRESS CRYZP PHON[ -- <br /> TENANT NAME I CONTACT FOR PERMR PHONE <br /> _ ���� A��� ��� rZ������-►��� <br /> CONTRACTOR �l7� SY�TtI'1'��, {,[/� ADDRESS CITY21 ✓HONE <br /> 2-1�1 r�f�r�l'f}�CE F-' D�. I�l _'� 1'� (�(-�,-GI FlC W'A �jf�v4�1 <br /> CONTR.LICENSE M I <br /> FI S�l✓1 � 'v 'LS7� 2,Zi" •-I �� <br /> USE OF BUILDING HEAT SOURCE CONTRA 7 PRICE OF WORN <br /> n�,�C� I _Eledric _Gas_Other � ��p— <br /> WORKDESCRIPTION �bCPc�-. 3��� SPI�-�N�L�S <br /> ( 'Ta ��l�t� c�zu�y <br /> �k'— �El�1H MT I rh I"�,v�vi'�S .. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toiiet A/C–air handling unHs <br /> _ Balhtub Forced air systems <br /> _ Lavatory(wash basin) — <br /> Shower _ Gas piping <br /> — _ Waterheater <br /> _ KNchen sink 8 disposa� _ Gas fireplace <br /> _ Dishwasher _, Gas range <br /> _ Clothes washer Cbthes dryer <br /> _ Laundry Iray Range hood <br /> _ Sink(service/bar/mop/etc.) Exhaust tan <br /> _ BackFlow preventer Heat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain Boller <br /> _ Floordrain Retrigeration <br /> _ Grease trap _ VI(oodstove <br /> _ Rootdrains Other <br /> Other — <br /> CITY OF EVERETT LOCAL SALES 7AX CO�E IS J105 <br /> i hereby ceritiy that I have read and examined this application and know the same to be true and cortect. Ail provisions of laws and <br /> ordinaces governing this type of work will be camplied with whether specified herein ar not.The granting of a pertnit does not presume <br /> to give author�y to violate or cancel tlie provision of any other stale or local law regulating construdion or the perfortnance af <br /> construdion.Thet I am authorized by the owner of this property ta peAortn the work for which application is made and I comply with the <br /> State CopMaqlors 1827�[:!N and 296200 WAC. <br /> � � %' �l (� o <br /> Sg� "of - NContractor/AuthorizetlAgent p �e � I <br /> i ���L <br />