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SEP-3-2Gi_l9 14:56 FROM:C�M HERTIIJG 425-745-1344 T0:14252578857 P: 1'2 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CGDAR STREET, EV[RETT, WA 98201 <br /> 425-257-8H70-FAX 425-257•8p57-ti�nvw.everettwa.org <br /> APPLICATIONS AFiE ACCEPTED FROM 8 AM TO 4 PM <br /> SRE A�DRESS PARCEL TAX I,D.# PERMIT <br /> �3 �'�` � � o0�v�17oc�ooazieo � il <br /> LEGA LO7Np. BLOCK TRACTOp5U6DINSIO�JA <br /> D[SC. <br /> UDRESS C V21P VHONE <br /> Joh� U r �, ��3 lo�" Dr �E E11uZ`ct,�'-I g2�8 4Z5 7(�32 �3 �I <br /> TE-NANiNA1dE CONTACTFORPEqMiT PHONE i <br /> -�fl1ST]CZ """�� ��' �Q•�•L�•� E�7AIL �. <br /> GLm NF0.-;1 n ° iP � t{.Z�J�q �c{c � <br /> CO�fIit.LICENSEp 9 1�i5 P�roQdwC�; 612,t4� c�82p <br /> _ �'1 f-!��ki_a� �R�'JK.�- J <br /> USE OF I3UILOING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Eloctrlc YGas^Other �C}�^,.� � Q .�-�, <br /> WOaK O�SCRIPTION <br /> I��s�ull -I�:.� �I r's s �,:�a�e-�r f�aa�r <br /> PLUMBING MECHANICAL <br /> ��0• TYPE OF FIXTURG OR REM ry0. 1YpE OF FIXTURE Oq REM <br /> — TO��ef NC-airhandlingunits <br /> 6a�tub Farccd alr systems <br /> � Lavatory(wash baain) <br /> „ Gas pip�^g <br /> _ Snower wamr healer <br /> _ Klichef�5ink&dispo;al Gas��repldce <br /> _ DishwasYier Gas range <br /> Clpthes washer _ Clothes dryer <br /> i lvator heater Ranga hood <br /> Sink(servlce�badmop/cic.) � Exhaust lan <br />, � BackAow pravonler Heat pump <br /> Urinal Unit heater <br /> _ Drinking FOUMain Boilcr <br /> Floor dmin � Re(rigera6on <br /> _ Grease trap Wa�stove <br /> Roof dr�InS � Other <br /> ^ Qthar <br /> CRY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hrreby ceritify that I have read and examined Nis application and know the same to be tn.e and correct. All provi5�ons of la•r:s a�d <br /> ardinoce7$J�ve�pi�p this type 0�wOrk�vill ba COfnplied�vAh whEth�r speciti2d hefBin o�nOL 111e g�anting Of 1 p•�rmi(dp25 OOt presume <br /> to plve aulhodry to violate or cancel the provisipn of any other slate or loral law regulating constfuction or ihe performance at <br /> con;�roction.That I am authorited by ihe owner ot thi;property to perlorm the wark for which appllcation is made and I compty niih the <br /> State Con;ractors La�v 7827 RCW and 29G.200 WAC. <br /> i na, rc of , ��J� \\ � "✓•� __ � <br /> p pwneri �ctor/Aulhonz=�; Data . <br />