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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> -125-�5i-8810 - FAX d25-257-8857 - �wvw.everettwa.org <br /> i <br /> APFLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED � <br /> � <br /> SI7E ADDRESS � PARCEL TAX I.D. # PERMIT# i <br /> �J 1 � 10' �UC . s�. (�tl � 3�`c�� i � oo Boyc�� -oa8 <br /> .c,��_' LOT NO. � 9LOCK I TRACT <br /> _ca...�� � � <br /> 01Y4ER AOORE5� CfTY21P PHONE <br /> �'• I � Il Sc� L 5 . MAt�(I �� t�(G l i _ `�,�215 IU` HI�IIe . �� kueveN- yas-brla-�8�� <br /> 7ENANT NAh1E I CONTACT FOR PERMIT � PHONE <br /> _M_(1,���� � MRN�R�G �t� I <br /> CL4TRACTOR ADORESS CITY2IP PHONE � <br /> � CONTR. LICENSE tt <br /> 1 _ I <br /> USE OF BUILOihG I HEA7 SOURCF I CONTRACT PRICE Of WORK <br /> � � QC.ILT F ft V 1�t��{ E.{�;��.L �Electnc Gas Other i <br /> � — — <br /> WORK �ESCRIPTICN � � <br /> PLUMBING MECHANICAL � <br /> NO. � TYPE OF FIXTURE OR ITEM NO. I TYP,:OF FIXTURE OR ITEM ; <br /> � <br /> _I Tc�iet _ NC—air handiing units i <br /> _� 6athtub Forced air systems <br /> _ LavaWry(wash basin) Gas piping � <br /> _ Shower Water heater <br /> I iGtchen sinY.8 disposal Gas freplace I <br /> _ Dishvrasher Gas 2c�e : <br /> _ CbNes washer ��n,•ies dryer j <br /> l.aunCry vay � Rarge hood <br /> ; Sirk (service/badmopletc.) ^ E�aust fan I <br /> _ Backflcw preventer _ F!eal pump I <br /> , Unnal Umi heater <br /> _ Gnnking Fountain _ Boiler I <br /> _ Floor drain Relrigeration <br /> Grease Vap Wocdstove � <br /> � Roof arains Olher <br /> ', `i Gber = <br /> CITY OF EVERETT LOCAL SALES TAX CO�E 19 710<_ I <br /> � I hereby cenGfy that I have read ara exam:ned this applicauon and know the same Io b��true antl correct. All provisions o(laws ana <br /> ordinac�s govemlrg this P/pe of work will be complied v+ith whether specified herein or not. The gran!ing o(a permit does not presume <br /> ;o give authonry ta•nolate or cancel the prcrosir,n of any other state or local law regulaUng conswction or the peRormance of <br /> :� atruc:ion. L�a!I am authonzed by the tr+mer of this property to pedorm the work for which application is made and I comply with the � <br /> Sldfe CortreC.Ors Law 182�RC�^: antl 296.200'NPC. ' <br /> �,n-v—�Tn,SC Cr.ti, n�( lY I � � I o�/ i <br /> S�gnat of �enen oi� ivac:orrF�ithor etl A�ent Date <br /> `/ I <br />