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_ _ <br /> � <br /> j - <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810—FAX.425-257-8857—wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PpOM e AM TO 4 PM 6 —�/ —n( <br /> SITE ADDRESS PARCEL TAX I.D.x RMIT A <br /> � v S. E. - - v <br /> LEGA LOTNO. BLOCK TRACTORSUBDIYISIONI <br /> DESC. <br /> OWN NOD ESS CTY21 PHONE <br /> SKaldCil ��c.v�e,�, 1:��� '1�d. � S2{��I ��� �-1- . 1�I(� `182p(D <br /> TENANTNAME COHTACTFORPERMIIT PHON l�n,.6�Z-O�'g <br /> v_��T� (lL U,�(� /-YI �L �..'I'1 L �1 � Y E-MAIL �Q �'�Cr�4��'I I�CQ <br /> ��1T1�D) ��A6 �1T02 � � <br /> CONTR.LICENSE N <br /> USE OF I:UILDING �� p� ,S j�, I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eleclric _Gas Olher 2� �� <br /> WORK DESCRIPTION r,e,-•I n CQ, �,�I$"flfl�{ S�'1Q,�VI f1Q 11 X f1.1.�`C S �/Y�'�'1 nF W S�Q�V 1� <br /> �n+ti, <br /> , J �J <br /> -�ix}u,res 3 l.q�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF Fl%TURE OR REM <br /> Toilet A/C-air handling units <br /> � 8athtub Forced ai�systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> IGtchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolbes washer Clothes dryer <br /> Water heatcr Range hood <br /> Sink(ssrvice/bar/mop/etc.) Exhaust tan <br /> _ Backflow prevonter Heat pump <br /> Urinal Unit hea[ar <br /> Drinking Fountain Boiler <br /> Floor drain Relrigeration <br /> Grease trep Woodstove <br /> Roo�drains 7 Other r`LIS'�'I�� <br /> � Other _ <br /> Fvi�-- <br /> qTY OF EVERETT LOCAL SALES TA7(CADE IS 9105 <br /> I hereby ceriGfy that I have read and examined this applicaGon and know the same to be true and correct. NI provisions of lavrs and <br /> ordinaces governing ihis type ot work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or locat law regulating construcUon or tne par�ormance ot <br /> construction.That I am authorized by the owner of this propeny to periam the work for which applicalior.is made and I comply with the <br /> State C .actors 7 CW and 296200 WAC. <br /> y�r��s 5/z c � <br /> ' natureo Owner! ntractorAuthonze gent ate I/ <br /> � � <br />