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-__�_ • <br /> PERMIT AP�PLOCATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201 <br /> 425-2S7-a810 -F/�( 425-257-3857-vnvw.everettwa.org <br /> APPLICqTIONS ARE ACCEPTED FROM 8 AM TO 4 PM / <br /> SITE ADDRE55 v `�� ( y'� <br /> PARCEL TAX I.D. # PERMIT k <br /> � � S � � go 3UC� -a <br /> l[GAL LOTNO. BLOCK TRACTOftSUBDIVISIONi! <br /> DESC. <br /> OWNER <br /> ADORESS CITY/ZIP PHONE <br /> Jf��, c c�_�11���-- �'t �3 <br /> TeNANTNAME '�--- �� �3 ' ga g� <br /> CONTACTFORP�RMIT pHONE <br /> oNtrincTort -�+�f11. � t�.� _ <br /> ��LYLOv-r1 l��Olo :�a�> ��'i t�� <br /> ..t.TVYV-t1 � � !'� �D�RESS E'MAIL.]GU 1�.1 L�L`�'f(lM__� <br /> � �1 �� ITY�ZIP 1 1 PH NE V'Py � <br /> CONTR. UCENSE x PL :�,r_y-t�I-L. �v� �y � �� C ��-C <br /> �3r �.��.,r,����.1 �g�` �1�i�; E <br /> USE OF BUIL�ING � <br /> HEAT SOURCE I CONTRACT PRICE OF WORK <br /> -�-L� „EleUric��g�Olher � � (�� <br /> WORK DESCRIP7'ION I`"1 <br /> �f-C._ '��Cl � I'l� (�Q 3 v ( (�ti !-L_ �_f � <br /> ----- � <br /> PLUMBING <br /> h�' 7YVE OF FlXNRE OR ITE1d M AH�C NICq'�— <br /> No. TVNe or rixruRe oR i��a <br /> : ro�Iet <br /> —, Bathtub A/C-air handling units <br /> ___ �avi��ry(Wash basm) � Forcr.d air syst?ms <br /> _ ShOwer _� Gas piping <br /> � Kitchen sink,;,tlisposal � Wa�ar heatr_r <br /> , Oishweshr.� _ Gas firep��r.c <br /> _� Clothes w;�ghrr _ Ga5 ra�gr <br /> � wafer heater � Clothe,nryer <br /> � Slnk (scrvice/bar/mop/�tC.) , R�ngr. hood <br /> _ Uar.k�ow pravenlcr � Exhaust tar <br /> _ Unnal � Fleat pUmp <br /> '— Drir,king Founlain ` U�if hnater <br /> ___ PIOor drain � 90i1e� <br /> a GreaSe Irap � Reingerali0n <br /> _ Rnof drain, Wood;fovr_ <br /> _ Othcr�_-- _ Othar <br /> -- --�------ � --�.�_� --- <br /> _—�-__ ' —`--� <br /> —'- --�z_� CITY OF EVERETf �—'--"- <br /> tOCq�Sa�ES 7qx COpE IS��OS `'�------ <br /> I hereby cett;fy lhal I have read antl r.xav:lned this aPpliwtion and know thc ,ame In tir. true an�corrPd All pi�vls�ons of laws antl <br /> Urdinar 9 q -1-- <br /> ues ovr:rnin this lype of work wlll be co ---�— <br /> to grve authority(o violate or cancei Ihr mpl;ed wuh vfiether specifieJ herein or no� 7 <br /> consV etion. T'hal i nm authonz d Provision ol any other slate or lor,al I�vi reguiatln�cons uction,IpQihea pennit UpCs nol pre;urne <br /> Stlte�p�����ya� by thn��,�e�of lhiS prODCrt <br /> � lnw 18.27 d��tl� Y�'�pertorm thF�1brk tor whi ����rmancr.of <br /> 200 Wq�. ch applica�ion i5 macfr, antl 1 comply witr,}h� <br /> 5�9 a�u e ot wner%Contr�ct r/hu erized� �� <br /> L/ g,, -�p���_ <br /> -�_�_ <br /> �'—�------_� <br /> __ ___ - _ --_ � <br />