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JUL-25-edb5 14:20 FROM: T0:14252578857 P.1 <br /> . <br /> : <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-w vw.everettwa.org ' .a 5.�-�' <br /> � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITEADDRESS ��� Ac� �� ���ELT�.OL.�� � PERMITN <br /> C�J )!/ <br /> LEGA LOTNO. BLOCK TRACT <br /> GESC. <br /> OWNER ADDRESS CIN21P PHONE <br /> �,(,� �rM�L¢�v ��e-, (Cor y �`�`'A-�e J'� �c-{-� 3�� s�Yc� <br /> TENAtJT NAME CONTACT FOR PERMIT PHONE <br /> Zc�a.'�L �Zr7?o 32�-�' <br /> co��J F't ��'�,� �'' V(CD/Z�'-� S � �,nin ir �^P�N�� "�/CL� <br /> CONTR.LICENSE ll , , !Q�u I�Q��D� ,p � <br /> �c�L /, v�J co T <br /> w.�Wc �� [ •t <br /> USE OF BUII.DING I HEAT SOURCE I CONTRACT PRICE OF WORK <br /> ���1/L �� • _Etectri� ,�Gas_Othor � l Q�� — <br /> I <br /> WORK UESCRIPT�ON <br /> ��' -� �� �,=r� h.�� c��� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE C!F FIXTURE OR ITEM <br /> Toilel A/C-air handling units <br /> 6alhtub Forced air systems ; <br /> _ Lavalory(wash basin) Gas piping I <br /> Shower � Waterheater <br /> Kitchen sink&di.p09P1 Gas fireplace <br /> Dishwasher Gas renge <br /> Clolhes washer Clolhes dryer <br /> Laundry troy _ Range hood <br /> Sink(servicelbar/mop/elc.) ._ Exhaust fan <br /> Back(!ow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain _ Boller <br /> Floor draln Relrigeralion <br /> Grease lrap _ Woodstove <br /> Roof drains _ Other <br /> Olhar �_ — <br /> CITY OF r'VERETT LOCAL SALES TAX CODE IS]105 <br /> I hereby ceritify thal I hava read antl exam(ned Ihls appilcatlon and know the same to be irue ana correct. All provlslons of laws an0 <br /> ordinaces governing this type ol work v:ill be complied with whelher specified herein or not.Tha r�ranling ot a permit does not presume <br /> to give auLhority to violate or cancel lhe provision of any other state or local law regulaGng consW ction or lhe pedormance ot <br /> construction.7hal I am authodzed by Uie owner of this property to p�the work for which applica�ion is made antl I comply with the <br /> State Co actors Law 1 . 7 RCw and 29:.200 WAC. <br /> � ,�-�� ���r <br /> Sgn re Owner Cantraclnr Author� tl Apenl D21e <br />